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Prognostic value of aberrant p53 immunoexpression for the recurrence of ependymoma: An analysis of 76 cases
Author(s) -
Korshunov Andrey,
Timirgaz Valery,
Golanov Andrey
Publication year - 1999
Publication title -
neuropathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.701
H-Index - 61
eISSN - 1440-1789
pISSN - 0919-6544
DOI - 10.1046/j.1440-1789.1999.00254.x
Subject(s) - ependymoma , pathological , medicine , proportional hazards model , multivariate analysis , oncology , hazard ratio , pathology , confidence interval
Intracranial ependymoma is the third most common primary brain tumor in children. Although clinical and histological criteria for ependymoma prognosis are recognized, studies have reported contradictory results. Prognostic significance based on the molecular biology of ependymomas has been reported in a few studies. Seventy‐six patients with intracranial ependymomas were examined retrospectively for p53 DO‐7 immunoexpression in tumor specimens. The results indicate significant association of aberrant p53 expression with high‐grade ependymomas and demonstrate a close correlation with recurrence‐free survival. All 22 of the p53‐positive high‐grade ependy‐momas had recurred within the first 24 months after operation with a median recurrence‐free survival time of 12 months. There were nine recurrences among 18 of high‐grade p53‐negative tumors with median recurrence‐free survival time of 27 months. A multivariate analysis using a Cox proportional hazard model including both clinical and pathological factors exhibited an independent prognostic value for the p53 positivity only ( P = 0.0015). A multivariate regression tree analysis (CART) graded tumors as follows: (i) low‐grade (36 cases, recurrence rate = 19%); (ii) high‐grade p53‐negative (18 cases, recurrence rate = 50%); and (iii) high‐grade p53‐positive (22 cases, recurrence rate = 100%). A novel classification of ependymomas is proposed that should prove useful in designing an optimal treatment strategy.