Intracranial Ependymomas

Kim, Young H.; Fayos, Juan V.

doi:10.1148/124.3.805

Cited by 90 publications

(24 citation statements)

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“…It has been reported that patients with high-grade ependymomas are more likely to seed; our findings support that prediction as well as the unfavorable prognosis associated with more anaplastic lesions [2,4,6,13].…”

Section: Discussionsupporting

confidence: 90%

“…Recently, several authors have recommended prophylactic spinal neuraxis radiation in cases of high-grade ependymoma [2,6,13]. Seeding in such cases is not a rare event and the risk of its occurrence must be factored into the treatment plan.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of seed ing is reported in various series to range from 0 to 34% [1,2,6,7,12,13,[15][16][17]. This variability may be partially explained by the fact that some series have insufficient follow-up data and a low autopsy percentage.…”

mentioning

confidence: 99%

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Seeding of Intracranial Ependymomas in Children

Renaudin¹,

Tullio²,

Brown³

1979

Pediatr Neurosurg

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19 cases of intracranial ependymomas were reviewed to determine the incidence of seeding. 4 patients demonstrated conclusive evidence of seeding in sites remote from the operative and irradiated field, 3 of whom had high-grade ependymomas. Clinical-pathological correlation disclosed a greater tendency to seeding and a worse prognosis among patients with high-grade ependymomas. A more aggressive therapeutic approach is indicated when high-grade ependymomas are involved.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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Seeding of Intracranial Ependymomas in Children

Renaudin¹,

Tullio²,

Brown³

1979

Pediatr Neurosurg

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“…35]. In part, this has been attrib uted to the ability of these neoplasms to disseminate throughout the ncuraxis [3,12,27,28]. Furthermore, ependymomas tend to occur in difficult locations, and fre quently invade vital structures, rendering total excision hazardous [9,21,22], In an attempt to improve outcome, radiation therapy, and more recently chemotherapy, have been used as adjuncts to surgery in the treatment of this disease.…”

mentioning

confidence: 99%

Prognostic Factors in Childhood Ependymomas

et al. 1990

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Between 1975 and 1989, 45 children with newly diagnosed intracranial ependymomas were treated at the authors’ institution. Patients were managed with aggressive surgical resection, followed by postoperative CT or MRI scans to evaluate the extent of resection. Most patients received involved-field radiation therapy, however 10 were treated with craniospinal axis irradiation for disseminated disease, or malignant histology. Beginning in 1983, all patients were also treated with adjuvant chemotherapy with 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU), vincristine, and cisplatinum. Four patients died in the immediate postoperative period for an operative mortality of 8.8%. The 5-year progression-free survival for the remaining 41 patients was 36%. Tumor location had little effect on survival, as the 5-year PFS for supratentorial tumors was 26%, compared with 40% for the posterior fossa lesions (ns). Neither histologic degree of malignancy, nor use of adjuvant chemotherapy impacted on survival. The extent of surgical resection, as determined by operative reports and postoperative imaging studies, was a major determinant of outcome , as patients with total or near-total resections experienced a 5-year PFS of 60%, compared with 21% for children with partial resection or biopsy (p < 0.01). It is concluded that the use of adjuvant chemotherapy with CCNU, vincristine , and cisplatinum does not improve progression-free survival in childhood ependymoma, and that the extent of surgical resection is a major determinant of outcome in this disesase.

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“…However, with the introduction of water-soluble myelographic contrast media, early involvement and the exact extent of the intraspinal spread may be demonstrated [2]. Intraspinal metastatic disease occasions a grave outlook requiring modification of radiation therapy fields and chemotherapeutic regimens [3,4]. We reviewed the myelographic features of intraspinal deposits in 20 children with histologically proven primary intracranial malignancy.…”

mentioning

confidence: 99%