BACKGROUND.The current analysis of outcomes in a large series of adult patientswith intracranial ependymal tumors contributes to the characterization of theprimary prognostic factors and to the therapeutic management of this rare disease,for which limited information is available in the literature.METHODS.The authors analyzed data on patient and tumor characteristics, treat-ment, and survival in a series of 70 patients age 17 years with pathologicdiagnoses of brain ependymal tumors from 4 institutions.RESULTS.The 5- and 10-year overall survival (OS) rates ( standard errors) were67% 6% and 50% 8%, respectively. The 5- and 10-year failure-free survival(FFS) rates were 43% 7% and 24% 6%, respectively. Younger age and infra-tentorial tumor location were associated with longer survival. Among patients withGrade 2 ependymoma (n 51), 21 (41%) received no postsurgical treatment. These21 patients had a 5-year OS rate of 78% 10% and a 10-year OS rate of 68% 13%;the 5- and 10-year FFS rates for these patients were 47% 12% and 12% 11%,respectively. Twenty-six patients with Grade 2 ependymoma (51%) received post-operative radiotherapy (RT). These 26 patients had a 5-year OS rate of 71% 9%and a 10-year OS rate of 59% 11%; the 5- and 10-year FFS rates for these patientswere 54% 10% and 34% 10%, respectively. Among patients with Grade 2ependymoma, neither OS nor FFS differed significantly between those who did notreceive postoperative RT and those who did; however, these two groups wereheterogeneous with respect to prognostic factors. On multivariate analysis, RT useexhibited a trend toward improved OS and was significantly predictive of improvedFFS.CONCLUSIONS.The current analysis does not rule out the possibility that deferral ofRT at the time of recurrence could have a detrimental effect on FFS or OS inpatients with Grade 2 ependymoma, regardless of the degree of ablation. The roleof postoperative RT for patients who undergo imaging-based macroscopic totalresection remains to be addressed
A multicenter study of the prognosis and treatment of adult brain ependymonal tumors.
MAGLI A;
2004-01-01
Abstract
BACKGROUND.The current analysis of outcomes in a large series of adult patientswith intracranial ependymal tumors contributes to the characterization of theprimary prognostic factors and to the therapeutic management of this rare disease,for which limited information is available in the literature.METHODS.The authors analyzed data on patient and tumor characteristics, treat-ment, and survival in a series of 70 patients age 17 years with pathologicdiagnoses of brain ependymal tumors from 4 institutions.RESULTS.The 5- and 10-year overall survival (OS) rates ( standard errors) were67% 6% and 50% 8%, respectively. The 5- and 10-year failure-free survival(FFS) rates were 43% 7% and 24% 6%, respectively. Younger age and infra-tentorial tumor location were associated with longer survival. Among patients withGrade 2 ependymoma (n 51), 21 (41%) received no postsurgical treatment. These21 patients had a 5-year OS rate of 78% 10% and a 10-year OS rate of 68% 13%;the 5- and 10-year FFS rates for these patients were 47% 12% and 12% 11%,respectively. Twenty-six patients with Grade 2 ependymoma (51%) received post-operative radiotherapy (RT). These 26 patients had a 5-year OS rate of 71% 9%and a 10-year OS rate of 59% 11%; the 5- and 10-year FFS rates for these patientswere 54% 10% and 34% 10%, respectively. Among patients with Grade 2ependymoma, neither OS nor FFS differed significantly between those who did notreceive postoperative RT and those who did; however, these two groups wereheterogeneous with respect to prognostic factors. On multivariate analysis, RT useexhibited a trend toward improved OS and was significantly predictive of improvedFFS.CONCLUSIONS.The current analysis does not rule out the possibility that deferral ofRT at the time of recurrence could have a detrimental effect on FFS or OS inpatients with Grade 2 ependymoma, regardless of the degree of ablation. The roleof postoperative RT for patients who undergo imaging-based macroscopic totalresection remains to be addressedPubblicazioni consigliate
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