Patterns of relapse for children with localized intracranial ependymoma Journal Article


Authors: De, B.; Khakoo, Y.; Souweidane, M. M.; Dunkel, I. J.; Patel, S. H.; Gilheeney, S. W.; De Braganca, K. C.; Karajannis, M. A.; Wolden, S. L.
Article Title: Patterns of relapse for children with localized intracranial ependymoma
Abstract: We examined patterns of relapse and prognostic factors in children with intracranial ependymoma. Records of 82 children diagnosed with localized intracranial ependymoma were reviewed. 52% first presented to our institution after relapse. Median age at initial diagnosis was 4 years (range 0–18 years). Gender was 55% male. Initial tumor location was infratentorial in 71% and supratentorial in 29%. Histology was WHO Grade II in 32% and Grade III in 68%. As part of definitive management, 99% had surgery, 70% received RT (26% 2D/3D-conformal RT[CRT], 22% intensity-modulated RT [IMRT], 22% proton), and 37% received chemotherapy. Median follow-up was 4.6 years (range 0.2–32.9). Overall, 74% of patients relapsed (50% local, 17% distant, 7% local + distant) at a median 1.5 (range 0.1–17.5) years. Five-year OS and FFS for patients presenting prior to relapse are 70% (95% confidence interval [CI], 50–83%) and 48% (95% CI 30–64%), respectively. On log-rank, superior overall survival (OS) was demonstrated for gross total resection (p = 0.03). Superior failure-free survival (FFS) was demonstrated for age < 5 years (p = 0.04). No difference in OS or FFS was found between 2D/3D-CRT versus IMRT/proton (p > 0.05). On multivariate analysis, age ≤ 5 was independently associated with a lower risk of death and failure versus older patients (p < 0.05). Contrary to previous reports, young age may not be a poor prognostic factor in patients who can tolerate intensive treatment. Future studies examining patients stratified by clinical and molecular attributes are warranted. © 2018, Springer Science+Business Media, LLC, part of Springer Nature.
Keywords: chemotherapy; surgery; radiation therapy; ependymoma; cns tumors
Journal Title: Journal of Neuro-Oncology
Volume: 138
Issue: 2
ISSN: 0167-594X
Publisher: Springer  
Date Published: 2018-06-01
Start Page: 435
End Page: 445
Language: English
DOI: 10.1007/s11060-018-2815-7
PROVIDER: scopus
PUBMED: 29511977
DOI/URL:
Notes: Article -- Export Date: 1 June 2018 -- Source: Scopus
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MSK Authors
  1. Ira J Dunkel
    250 Dunkel
  2. Yasmin Khakoo
    99 Khakoo
  3. Suzanne L Wolden
    417 Wolden
  4. Suchit Hitesh Patel
    10 Patel
  5. Brian Sandeep De
    9 De