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Supratentorial ependymomas: Prognostic factors and outcome analysis in a retrospective series of 46 adult patients
Author(s) -
Metellus Philippe,
FigarellaBranger Dominique,
Guyotat Jacques,
Barrie Marylin,
Giorgi Roch,
Jouvet Anne,
Chinot Olivier
Publication year - 2008
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.23530
Subject(s) - medicine , grading (engineering) , ependymoma , multivariate analysis , univariate analysis , progression free survival , cohort , prognostic variable , retrospective cohort study , population , proportional hazards model , surgery , radiology , oncology , overall survival , civil engineering , environmental health , engineering
BACKGROUND. Ependymomas account for 2% of all intracranial tumors in adults. Supratentorial ependymomas are less common than their infratentorial counterparts. To the authors' knowledge to date, the predictive values of surgery, histology, and patient‐related prognostic factors for these tumors remain unresolved. The authors report a series of adult patients with supratentorial ependymomas to characterize the roles of surgery and histology in tumor control. METHODS. The authors retrospectively studied a homogenous population of 46 adult patients who had supratentorial ependymomas from 24 French neurosurgical centers between 1990 and 2004. All clinicoradiologic and follow‐up data were analyzed, and a central pathologic review was performed by 2 certified neuropathologists. RESULTS. The mean (±standard error) 5‐ and 10‐year overall survival rates for the entire population were 57.1% ± 8.7% and 41.8% ± 9.9%, respectively. The 5‐ and 10‐year progression‐free survival rates for the entire cohort were of 33.8% ± 8.1% and 25.4 ± 8%, respectively. On both univariate and multivariate analysis, age <55 years, greater extent of surgery, and lower histologic grade were associated with longer overall and progression‐free survival. However, longer progression‐free survival but was not considered a candidate variable for the multivariate model, because data were available for only 34 of 46 patients. CONCLUSIONS. In association with age and extent of surgery, histologic grade was identified as a major prognostic factor in adult supratentorial ependymomas. The application of a simple and reproducible grading scheme using objective anaplastic criteria appeared to be both useful practically and clinically applicable. The role of adjuvant radiotherapy for patients with incompletely resected, low‐grade ependymomas needs to be investigated further. Cancer 2008. © 2008 American Cancer Society.