BACKGROUND: Recurrence occurs in almost 50% of patients with intracranial ependymoma, and their outcome following recurrence is poor. METHODS: We retrospectively reviewed the medical records of 22 patients with intracranial ependymoma and subsequent relapse(s) (59 recurrences) treated at Children's Hospital Los Angeles or New York University between January 1997 and December 2012. RESULTS: Median duration of follow-up was 52 months (7-171 months). Median age at initial diagnosis was 4 years (0.3-19 years) with 8 patients younger than 3 years at presentation. Eleven patients had anaplastic and 11 cellular pathologies. Eighteen patients had infratentorial tumors at diagnosis and 3 (all infratentorial) had metastatic spinal cord involvement at presentation. Cerebrospinal fluid involvement was not identified at diagnosis or relapse. Median time to first recurrence was 16 months (1.3 to 115 months). The number of recurrences in each patient ranged from 1 to 9 (median = 2). Thirty-seven recurrences (63%) were detected asymptomatically by surveillance imaging. Fifteen recurrences (26%) arose outside the initial tumor site. Recurrences were treated by surgical resection (45), with irradiation (30), and with various oral chemotherapies (23) with (7) or without (16) conventional chemotherapy. The 5 and 10 year overall survival rates from first recurrence were 0.37 ± 0.14 and 0.25 ± 0.14. CONCLUSION: Prolonged (5-10 year) survival from first relapse was noted in over one-quarter of our patients. It remains unclear whether early radiographic diagnosis, differing treatment modalities beyond radical surgical resection or possibly unrecognized biological differences contributed towards this prolonged survival.
BACKGROUND: Recurrence occurs in almost 50% of patients with intracranial ependymoma, and their outcome following recurrence is poor. METHODS: We retrospectively reviewed the medical records of 22 patients with intracranial ependymoma and subsequent relapse(s) (59 recurrences) treated at Children's Hospital Los Angeles or New York University between January 1997 and December 2012. RESULTS: Median duration of follow-up was 52 months (7-171 months). Median age at initial diagnosis was 4 years (0.3-19 years) with 8 patients younger than 3 years at presentation. Eleven patients had anaplastic and 11 cellular pathologies. Eighteen patients had infratentorial tumors at diagnosis and 3 (all infratentorial) had metastatic spinal cord involvement at presentation. Cerebrospinal fluid involvement was not identified at diagnosis or relapse. Median time to first recurrence was 16 months (1.3 to 115 months). The number of recurrences in each patient ranged from 1 to 9 (median = 2). Thirty-seven recurrences (63%) were detected asymptomatically by surveillance imaging. Fifteen recurrences (26%) arose outside the initial tumor site. Recurrences were treated by surgical resection (45), with irradiation (30), and with various oral chemotherapies (23) with (7) or without (16) conventional chemotherapy. The 5 and 10 year overall survival rates from first recurrence were 0.37 ± 0.14 and 0.25 ± 0.14. CONCLUSION: Prolonged (5-10 year) survival from first relapse was noted in over one-quarter of our patients. It remains unclear whether early radiographic diagnosis, differing treatment modalities beyond radical surgical resection or possibly unrecognized biological differences contributed towards this prolonged survival.
Authors: Pietro Spennato; Giancarlo Nicosia; Lucia Quaglietta; Vittoria Donofrio; Giuseppe Mirone; Giuliana Di Martino; Elia Guadagno; Maria Laura del Basso de Caro; Daniele Cascone; Giuseppe Cinalli Journal: Childs Nerv Syst Date: 2015-09-09 Impact factor: 1.475
Authors: Wael Alshaya; Vivek Mehta; Beverly A Wilson; Susan Chafe; Keith E Aronyk; Jian-Qiang Lu Journal: Childs Nerv Syst Date: 2015-05-10 Impact factor: 1.475
Authors: Derek S Tsang; Louise Murray; Vijay Ramaswamy; Michal Zapotocky; Uri Tabori; Ute Bartels; Annie Huang; Peter B Dirks; Michael D Taylor; Cynthia Hawkins; Eric Bouffet; Normand Laperriere Journal: Neuro Oncol Date: 2019-03-18 Impact factor: 12.300
Authors: Jonas E Adolph; Gudrun Fleischhack; Ruth Mikasch; Julia Zeller; Monika Warmuth-Metz; Brigitte Bison; Martin Mynarek; Stefan Rutkowski; Ulrich Schüller; Katja von Hoff; Denise Obrecht; Torsten Pietsch; Stefan M Pfister; Kristian W Pajtler; Olaf Witt; Hendrik Witt; Rolf-Dieter Kortmann; Beate Timmermann; Jürgen Krauß; Michael C Frühwald; Andreas Faldum; Robert Kwiecien; Udo Bode; Stephan Tippelt Journal: Neuro Oncol Date: 2021-06-01 Impact factor: 12.300