Lack of histopathological correlation of malignant ependymomas with postoperative survival

Abstract

It is widely believed that an important determinant of clinical behavior and prognosis in patients harboring an ependymoma is the histological grade of malignancy of the tumor. Excluding from the present analysis examples of ependymoblastoma (a highly cellular, embryonal tumor occurring in children, with a notably poor prognosis and a tendency to subarachnoid spread), an attempt was made to correlate 15 cases of histologically malignant ependymoma with clinical recurrence and postoperative patient survival times. Ten patients (67%) were alive from 15 months to 14 years after surgery (median survival time 8.8 years); one patient had a histologically benign recurrence 11 years after surgical resection. Five patients (33%) died from a local recurrence of their tumor; their postoperative survival times ranged from 13 months to 6 years (median 2.5 years). The prognosis of malignant ependymomas is therefore highly variable. No correlation was possible between the tumor's histological features, site, or likelihood of recurrence. This lack of clinicohistopathological concordance contrasts with the known correlations that exist in astrocytomas.

Ependimomas del filum terminal. Análisis de 20 casos consecutivos

“…El papel de la radioterapia es controvertido. Ross y Rubinstein 33 en una revisión sobre 131 casos de ependimomas mixopapilares no encuentran diferencias importantes entre los casos radiados y los no radiados después de resección completa o incompleta 46 . Sin embargo, numerosas series sugieren que la radiación es el tratamiento indicado en casos de resecciones incompletas, debido a la alta tasa de recidivas, aunque en muchas de estas series, aparecen mezclados ependimomas del filum con ependimomas puramente intramedulares (grados II) o incluso intracraneales.…”

Pediatric Brain Tumors: Current Treatment Strategies and Future Therapeutic Approaches

“…146 The high variability among neuropathologists with reported discordance of 69% between central and local review remains a challenge in developing new therapeutics and assess the response rates in different clinical trials. 147,148 In a recent analysis of a population-based registry, 5-year OS was reported to be 57.1% (Ϯ 2.3%).…”

Genetic abnormalities detected in ependymomas by comparative genomic hybridisation

“…Histological features of anaplasia, such as mitoses, microvascular proliferation and necrosis, serve as indicators of biological behaviour in other gliomas, including diffuse astrocytic tumours and oligodendrogliomas (Cohadon et al, 1985;Burger and Green, 1987;Ellison, 1998). However, the biological significance of these morphological features in ependymoma remains unclear; clinicopathological studies have provided conflicting evidence on the prognostic value of dividing ependymomas into classic (WHO grade 2) and anaplastic (grade 3) variants (Ross and Rubinstein, 1989;Sutton et al, 1990;Schiffer et al, 1991;Gerszten et al, 1996;Bouffet et al, 1998;Figarella-Branger et al, 2000).…”