Ependymoma: Internal Correlations among Pathological Signs: The Anaplastic Variant

Schiffer, Davide; Chio, A; Cravioto, Humberto; Giordana, Maria Teresa; Migheli, Antonio; Soffietti, Riccardo; Vigliani, Maria Claudia

doi:10.1227/00006123-199108000-00006

Cited by 89 publications

(53 citation statements)

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“…Results also were comparable with respect to 5-and 10-year FFS rates, which were 43% and 24%, respectively, in the current series and 42-55% and 27-43%, respectively, in the literature. 10,15,16,18 The possible correlation between tumor grade and survival is controversial, 5,9,11,12,18,20 -22 with differences in findings probably being attributable to sample size, anatomic tumor location, variability in the definition of anaplasia, [23][24][25] discrepancies in histologic diagnoses, 26 and the inclusion in some series of ependymoblastoma and subependymoma, which exhibit different biologic behavior and should be analyzed separately. Anaplastic ependymoma is even less common in the adult population, accounting for approximately 20% of all ependymal tumors in the current series; this figure is consistent with previously reported rates of 17-28%.…”

Section: Prognostic Factorsmentioning

confidence: 99%

A multicenter study of the prognosis and treatment of adult brain ependymal tumors

Reni

Brandes

Vavassori

et al. 2004

Cancer

105

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BACKGROUNDThe current analysis of outcomes in a large series of adult patients with intracranial ependymal tumors contributes to the characterization of the primary prognostic factors and to the therapeutic management of this rare disease, for which limited information is available in the literature.METHODSThe authors analyzed data on patient and tumor characteristics, treatment, and survival in a series of 70 patients age > 17 years with pathologic diagnoses of brain ependymal tumors from 4 institutions.RESULTSThe 5‐ and 10‐year overall survival (OS) rates (± standard errors) were 67% ± 6% and 50% ± 8%, respectively. The 5‐ and 10‐year failure‐free survival (FFS) rates were 43% ± 7% and 24% ± 6%, respectively. Younger age and infratentorial tumor location were associated with longer survival. Among patients with Grade 2 ependymoma (n = 51), 21 (41%) received no postsurgical treatment. These 21 patients had a 5‐year OS rate of 78% ± 10% and a 10‐year OS rate of 68% ± 13%; the 5‐ and 10‐year FFS rates for these patients were 47% ± 12% and 12% ± 11%, respectively. Twenty‐six patients with Grade 2 ependymoma (51%) received postoperative radiotherapy (RT). These 26 patients had a 5‐year OS rate of 71% ± 9% and a 10‐year OS rate of 59% ± 11%; the 5‐ and 10‐year FFS rates for these patients were 54% ± 10% and 34% ± 10%, respectively. Among patients with Grade 2 ependymoma, neither OS nor FFS differed significantly between those who did not receive postoperative RT and those who did; however, these two groups were heterogeneous with respect to prognostic factors. On multivariate analysis, RT use exhibited a trend toward improved OS and was significantly predictive of improved FFS.CONCLUSIONSThe current analysis does not rule out the possibility that deferral of RT at the time of recurrence could have a detrimental effect on FFS or OS in patients with Grade 2 ependymoma, regardless of the degree of ablation. The role of postoperative RT for patients who undergo imaging‐based macroscopic total resection remains to be addressed. Cancer 2004. © 2004 American Cancer Society.

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Section: Prognostic Factorsmentioning

confidence: 99%

A multicenter study of the prognosis and treatment of adult brain ependymal tumors

Reni

Brandes

Vavassori

et al. 2004

Cancer

105

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“…Do total de ependimomas até ¼ podem ser anaplásicos ou malignos 4,8 . Em nossa casuística, os ependimomas corresponderam a 3,04% das neoplasias neuroepi- RT, ressecção total; RP, ressecção parcial; RTx, radioterapia; QT, quimioterapia.…”

Section: Discussionunclassified

“…Ependimomas são neoplasias de celularidade moderada, com morfologia nuclear monótona 1,2,4,6,8,11,12 . Os principais achados são as rosetas ependimárias, representadas por células colunares dispostas em torno de um canal central, e as pseudo-rosetas perivasculares, constituídas de células neoplásicas circunjacentes aos vasos 1,2,4,6,8,11,12 .…”

Section: Fig 5 Corte Histológico De Ependimoma Composto Por Células unclassified

“…Os principais achados são as rosetas ependimárias, representadas por células colunares dispostas em torno de um canal central, e as pseudo-rosetas perivasculares, constituídas de células neoplásicas circunjacentes aos vasos 1,2,4,6,8,11,12 . Degeneração mixóide, calcificação, necrose e focos de hemorragia podem ser observados 1,2,4,6,8,11,12 . Nas formas anaplásicas há aumento da celularidade, mitoses, proliferação vascular e por vezes focos de necrose 8 (Fig 5).…”

Section: Fig 5 Corte Histológico De Ependimoma Composto Por Células unclassified

“…Degeneração mixóide, calcificação, necrose e focos de hemorragia podem ser observados 1,2,4,6,8,11,12 . Nas formas anaplásicas há aumento da celularidade, mitoses, proliferação vascular e por vezes focos de necrose 8 (Fig 5). A análise imunohistoquímica evidencia reatividade focal para GFAP, havendo reação proeminente nas pseudorosetas 13,14 .…”

Section: Fig 5 Corte Histológico De Ependimoma Composto Por Células unclassified

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Ependimomas: achados clínicos, epidemiológicos e anatomopatológicos de 22 casos

Torres

Filho²,

Netto³

et al. 1999

Arq. Neuro-Psiquiatr.

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RESUMO -Ependimomas são neoplasias compostas por células ependimárias neoplásicas, manifestando-se predominantemente em crianças e adultos jovens. Relatamos os achados clínicos, epidemiológicos e anatomopatológicos de 22 casos de ependimomas. Dos 22 casos analisados, 14 ocorreram em pacientes do sexo masculino e 8 em pacientes femininos. As idades variaram de 1 a 58 anos, com média de 24,63 anos. Quanto à localização, 10 casos acometeram medula, 7 ocorreram em hemisférios cerebrais, 2 intraventriculares e 1 no tronco cerebral. Os sinais e sintomas observados incluiram redução da força muscular (59,1% dos pacientes), alterações da marcha (36,3%), alterações da sensibilidade(36,3%), hiperreflexia e sindrome de hipertensão endocraniana, com período de evolução variando de 15 dias a 8 anos, com média de 17,58 meses. Sete pacientes foram submetidos a ressecção cirúrgica total , 7 a exérese parcial, 4 a exérese parcial associada a radioterapia adjuvante, 3 a ressecção parcial seguida de quimioterapia e 1 a tumorectomia total associada a radioterapia. Evidenciou-se taxa de recidiva tumoral total de 18,2%. Estes achados aproximam-se dos encontrados na literatura internacional, corroborando para a compreensão do comportamento biológico deste tumor. PALAVRAS-CHAVE: ependimomas, neoplasias do sistema nervoso central, tumores cerebrais. Ependymonas: clinical, epidemiological and pathological findings of 22 casesABSTRACT -Ependymomas are composed of neoplastic ependymal cells, affecting mainly children and young adults. We report the clinical and pathological findings of 22 cases of ependymomas. Fourteen patients were males and 8 were females. The ages ranged between 1 and 58 years, with a mean of 24.63 years. The symptoms reflected the growth and topography of the tumours; muscle weakness (59.1%), gait disorders (36.3%), sensitive disorders (36.3%), hyperreflexia and intracranial hypertension syndrome were the most frequent symptoms. Ten tumours affected the medulla, 7 the cerebral hemispheres, 2 the cerebral ventricles and 1 brain stem. Seven patients were submitted total resection of the tumor, from which one received adjuvant radiotherapy. 15 other patients were submitted to partial resection; from which 4 received adjuvant radiotherapy, 3 adjuvant chemotherapy and 1 chemotherapy and radiotherapy. The recurrence rate was 18.2%. These results are similar with the literature and may contribute to further understanding the biological behavior of these tumours.KEY WORDS: ependymomas, central nervous system tumours, brain tumours.Os ependimomas se originam da camada ependimária que recobre os ventrículos cerebrais e o canal central da medula espinhal, manifestando-se em crianças e adultos jovens, com características morfológicas e comportamento biológico extremamente variáveis [1][2][3][4] . Relatamos os achados

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Analyses of prognostic factors in a retrospective review of 92 children with ependymoma: Italian Pediatric Neuro-Oncology Group

Perilongo

Massimino

Sotti

et al. 1997

Med. Pediatr. Oncol.

180

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Ependymoma: Internal Correlations among Pathological Signs: The Anaplastic Variant

Cited by 89 publications

References 0 publications

A multicenter study of the prognosis and treatment of adult brain ependymal tumors

A multicenter study of the prognosis and treatment of adult brain ependymal tumors

Ependimomas: achados clínicos, epidemiológicos e anatomopatológicos de 22 casos

Analyses of prognostic factors in a retrospective review of 92 children with ependymoma: Italian Pediatric Neuro-Oncology Group

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