Prognostication, treatment strategies and clinical outcomes in ependymoma diagnosed patients
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2016 Nova Science Publishers, Inc. Background and Purpose. Ependymoma is a rare primary brain tumor that arises from the ependymal cells of the intra-ventricular central nervous system (CNS) parenchyma with a propensity to affect both children and adults. This study aims to investigate the effects of gender, age, race, tumor grade, and treatment on clinical outcomes of ependymoma diagnosed patients. Methods. Retrospective clinical analysis of ependymoma and systematic review of histological data were included in this study from the Scott and White Brain Tumor Registry collected from 1976-2013. Results. About 30% of pediatric ependymomas were diagnosed in children younger than three years of age. Patients with completely resected tumors have an estimated 5- year survival rate of 67-80%, compared to an estimated 5-year survival rate of 22-47% in patients with incompletely resected tumors. Patients treated with post-operative radiation have a better outcome than patients who do not receive a radiation. Focal radiation to the site of the tumor lowers the risk of tumor recurrence at the site of origin. Ependymoma recurrence was observed in patients with grade III and II tumors. Ependymomas rarely metastasize outside of the CNS. Most patients who deceased after treatment were under the age of 25. Pediatric 5- year survival rate was approximately 66% compared with the adult 5-year survival rate which was 78%. The 5-year male and female survival rates were in average of 80% and 60%, respectively. The 5-year survival rates of the White patients and patients of all other ethnicities as a single group were 73% and 75%, respectively. Patients with primary tumor sites in brain stem, frontal lobe, and parietal lobe have an excellent overall survival and low risk of tumor recurrence. Conclusion. This study exhibits that surgical treatment with attempted gross total resection is a gold standard in treatment of ependymoma. The extent of surgical resection, age, and amount of tumor remaining after surgery are the primary factors influencing survival. Primary tumor site is another important prognostic factor for evaluation of short and long-term outcomes of ependymoma. Radiation therapy requires more future studies in order to elucidate more definitive treatment guidelines.
