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Both location and age predict survival in ependymoma: A SEER study
Author(s) -
McGuire Courtney S.,
Sainani Kristin L.,
Fisher Paul Graham
Publication year - 2009
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.21806
Subject(s) - medicine , ependymoma , proportional hazards model , multivariate analysis , radiation therapy , univariate analysis , survival analysis , epidemiology , surveillance, epidemiology, and end results , log rank test , oncology , population , univariate , cancer registry , multivariate statistics , surgery , statistics , mathematics , environmental health
Background Studies have suggested that supratentorial ependymomas have better survival than infratentorial tumors, with spinal tumors having the best prognosis, but these data have been based on small samples. Using a population‐based registry of ependymomas, we analyzed how age, gender, location, race and radiotherapy influence survival in children. Methods We queried the Surveillance Epidemiology End Results database (SEER‐17) from 1973 to 2003, strictly defining ependymomas by histology. Site codes were used to distinguish between supratentorial, infratentorial, and spinal tumors when available. Outcomes were compared by location, age, gender, race and radiotherapy, using Kaplan–Meier analysis and logrank tests. Cox regression was completed, incorporating all significant covariates from univariate analysis. Results Six hundred thirty‐five children were identified with an overall 5‐year survival of 57.1 ± standard error (SE) 2.3%. Increasing age was associated with improved survival ( P < 0.0001). Five‐year survival by location was 59.5 ± SE 5.5% supratentorial, 57.1 ± SE 4.1% infratentorial and 86.7 ± SE 5.2% spinal. Radiotherapy of the infratentorial tumors resulted in significantly improved survival in both univariate analysis (logrank P < 0.018) and multivariate analysis restricted to this tumor location ( P = 0.033). Using multivariate analysis that incorporated all tumor locations, age ( P < 0.001) and location ( P = 0.020) were significant predictors for survival. Conclusions Age and location independently influence survival in ependymoma. Spinal tumors are associated with a significantly better prognosis than both supratentorial and infratentorial tumors, and may represent a distinct biological entity. Radiotherapy appears beneficial for survival in patients with infratentorial ependymoma. Pediatr Blood Cancer 2009;52:65–69. © 2008 Wiley‐Liss, Inc.