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Journal of Neuro-Oncology

, Volume 68, Issue 3, pp 255–261 | Cite as

Multivariate Analysis of Clinical Prognostic Factors in Children with Intracranial Ependymomas

  • Tang-Her Jaing
  • Huei-Shyong Wang
  • Pei-Kwei Tsay
  • Chen-Kan Tseng
  • Shih-Ming Jung
  • Kuang-Lin Lin
  • Tai-Ngar Lui
Clinical Study

Abstract

The optimal postoperative management of pediatric intracranial ependymomas is controversial. We analyzed clinical prognostic factors for their influence on outcome in such children. Our retrospective series included 15 with supratentorial and 28 with infratentorial tumors. Twenty ependymomas were grade II, and 23 were anaplastic. Complete resection was performed in 18 patients, incomplete resection in 19, and stereotactic biopsy in 6. Radiotherapy was done in 31 patients and chemotherapy in 13. The surviving patients have been followed 8–232 months (median: 69 months). The median survival time was 30 months, and 5-year overall survival and progression-free survival rates were 53.9% and 45.9%, respectively. By tumor site: supratentorial, 56.6% and 50.9%; infratentorial, 52.3% and 42.5%. Multivariate analysis identified complete resection (5-year progression-free survival, 71.8%) and age <3 years old as significant favorable and adverse prognostic features (relative risk, 2.59; 95% CI, 1.05–6.38), respectively. Twenty-six children relapsed 1–107 months after diagnosis (median: 12 months). Relapses were local in 22 cases, and combined local and distant in three cases. Only one of 15 patients with supratentorial tumors developed isolated spinal metastasis. Failure at the primary site is the major obstacle to improve cure rates. The extent of surgical resection and age were the only statistically significant prognostic factors.

chemotherapy children intracranial ependymoma radiotherapy survival 

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Copyright information

© Kluwer Academic Publishers 2004

Authors and Affiliations

  • Tang-Her Jaing
    • 1
  • Huei-Shyong Wang
    • 2
  • Pei-Kwei Tsay
    • 3
  • Chen-Kan Tseng
    • 4
  • Shih-Ming Jung
    • 5
  • Kuang-Lin Lin
    • 2
  • Tai-Ngar Lui
    • 6
  1. 1.Division of Hematology and Oncology, Department of PediatricsChang Gung Children's HospitalTaoyuanTaiwan
  2. 2.Division of Neurology, Department of PediatricsChang Gung Children's HospitalTaoyuanTaiwan
  3. 3.Department of Public Health and Center of Biostatistics, College of MedicineChang Gung UniversityTaoyuanTaiwan
  4. 4.Department of Radiation OncologyChang Gung Memorial HospitalTaoyuanTaiwan
  5. 5.Department of PathologyChang Gung Memorial HospitalTaoyuanTaiwan
  6. 6.Division of Neurosurgery, Department of SurgeryChang Gung Memorial HospitalTaoyuanTaiwan

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