Syed I Khalid1, Ryan Kelly2, Owoicho Adogwa3, Adam Carlton4, Josha Woodward1, Shahjehan Ahmed1, Ryan Khanna1, Carlos Bagley5, Joseph Cheng6, Sanjit Shah6, Ankit I Mehta4. 1. Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois, USA. 2. Georgetown University School of Medicine, Washington, D.C., USA. 3. Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois, USA. Electronic address: owoicho.adogwa@gmail.com. 4. Chicago Medical School, North Chicago, Illinois, USA. 5. Department of Neurosurgery, The University of Illinois at Chicago, Chicago, Illinois, USA. 6. Department of Neurosurgery, University of Texas Southwestern, Dallas, Texas, USA.
Abstract
OBJECTIVE: Pediatric intramedullary spinal cord ependymomas represent a rare central nervous system neoplasm with few available data regarding incidence and outcomes. To this end, large population-based studies are needed to assess the epidemiology and survival risk factors associated with these tumors in the hope of better understanding these tumors as well as improving outcomes. This retrospective study was undertaken to explore factors that may influence survival in pediatric patients with intramedullary spinal cord ependymomas. METHODS: Using the SEER (Surveillance Epidemiology and End Results) database, a prospective cancer registry, we retrospectively assessed survival in histologically confirmed spinal ependymomas in patients 17 years of age and younger. Survival was described with Kaplan-Meier curves, and a multivariate regression analysis was used to assess the association of several variables with survival, controlling for confounding variables. RESULTS: Invasive tumor extension (P < 0.001) was associated with decreased survival, whereas gross total resection (P = 0.028) correlated with better rates of survival. Age, gender, tumor size, tumor extension, the use and sequence of radiation therapy, or use of chemotherapy were not found to have a statistically significant association with survival outcomes. CONCLUSIONS: Invasive ependymomas occurring in the spine have a worse prognosis, whereas higher tumor grades do not clearly show worse rates of survival. Early diagnosis and surgery seem to be associated with improved survival and outcomes, whereas radiation therapy and chemotherapy have an unclear role.
OBJECTIVE: Pediatric intramedullary spinal cord ependymomas represent a rare central nervous system neoplasm with few available data regarding incidence and outcomes. To this end, large population-based studies are needed to assess the epidemiology and survival risk factors associated with these tumors in the hope of better understanding these tumors as well as improving outcomes. This retrospective study was undertaken to explore factors that may influence survival in pediatric patients with intramedullary spinal cord ependymomas. METHODS: Using the SEER (Surveillance Epidemiology and End Results) database, a prospective cancer registry, we retrospectively assessed survival in histologically confirmed spinal ependymomas in patients 17 years of age and younger. Survival was described with Kaplan-Meier curves, and a multivariate regression analysis was used to assess the association of several variables with survival, controlling for confounding variables. RESULTS: Invasive tumor extension (P < 0.001) was associated with decreased survival, whereas gross total resection (P = 0.028) correlated with better rates of survival. Age, gender, tumor size, tumor extension, the use and sequence of radiation therapy, or use of chemotherapy were not found to have a statistically significant association with survival outcomes. CONCLUSIONS: Invasive ependymomas occurring in the spine have a worse prognosis, whereas higher tumor grades do not clearly show worse rates of survival. Early diagnosis and surgery seem to be associated with improved survival and outcomes, whereas radiation therapy and chemotherapy have an unclear role.
Authors: Rebecca L Achey; Sierra Vo; Gino Cioffi; Haley Gittleman; Julia Schroer; Vishesh Khanna; Robin Buerki; Carol Kruchko; Jill S Barnholtz-Sloan Journal: Neurooncol Pract Date: 2020-05-09