Predictors of survival in patients with spinal ependymoma

Lin, Yimo; Smith, Zachary A.; Wong, Ashley; Melkonian, Stephanie C.; Harris, Dominic A.; Lam, Sandi

doi:10.1179/1743132815y.0000000041

Cited by 40 publications

(24 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Multiple previous reports have investigated outcomes based on extent of surgical resection. It is a near universal finding that GTR improves outcomes, often measured as progression-free survival (PFS); while not statistically significant in this cohort there was a trend towards improvement in OS in patients receiving GTR in this analysis [6][7][8][9][10][11][12][13][14]. The few mean tumor size among those receiving RT (4.6 cm) was significantly larger than among those not receiving RT (3.2 cm, p = 0.0002).…”

Section: Discussioncontrasting

confidence: 51%

See 1 more Smart Citation

Myxopapillary ependymoma: a SEER analysis of epidemiology and outcomes

2016

View full text Add to dashboard Cite

Myxopapillary ependymoma (MPE) is an exceedingly rare tumor histology. While surgery is clearly the treatment of choice, controversy exists regarding the role of adjuvant radiotherapy (RT). Using the Surveillence, epidemiology, and end results (SEER) database, we aimed to determine the epidemiology, prognostic factors, and treatment-related outcomes for MPE. A total of 773 cases were found in the SEER database. The incidence in the American population was found to be 1.00 per million person-years. On multivariate analysis, receipt of surgery (HR = 0.14, CI = 0.06-0.35, p < 0.001), receipt of RT (HR = 4.06, CI = 1.87-8.81, p < 0.001), age less than 30 (HR = 0.24, CI = 0.08-0.72, p = 0.01), and Caucasian race (HR = 0.37, CI = 0.13-0.996, p = 0.049) were statistically significant prognostic factors. The mean tumor size among those receiving RT (4.6 cm) was significantly larger than among those not receiving RT (3.2 cm, p = 0.0002). Those who lived in metropolitan areas were more likely to receive RT than those who did not. Given multiple previous studies show that RT improves PFS and the discrepancy in tumor size, selection bias is likely a significant contributor to the apparent negative impact of RT on OS. Regardless, surgery remains the most crucial aspect in the care of patients with MPE.

show abstract

Section: Discussioncontrasting

confidence: 51%

“…As shown in Fig. 1, the incidence of at all [9,12,20,21]. A retrospective study from Case Western demonstrated that, while adjuvant RT had no impact on recurrence-free survival, salvage RT was associated the onset of a second recurrence [20].…”

Section: Epidemiologymentioning

confidence: 94%

Myxopapillary ependymoma: a SEER analysis of epidemiology and outcomes

2016

View full text Add to dashboard Cite

show abstract

“…Some studies have demonstrated the influence of age on survival outcomes in patients with spinal ependymomas. In a previous analysis of the SEER database, Lin et al [ 14 ] demonstrated that younger age was associated with improved long-term survival ( P = .01). Alshaya et al [ 11 ] similarly performed an autopsy case study and literature review of classic low-grade ependymoma, describing that younger age was the only risk factors for patients with TR of the lesion.…”

Section: Discussionmentioning

confidence: 99%

Outcome predictors in the management of intramedullary classic ependymoma

et al. 2018

View full text Add to dashboard Cite

This is a retrospective study.The aim of this study was to illustrate the survival outcomes of patients with classic ependymoma (CE) and identify potential prognostic factors.CE is the most common category of spinal ependymomas, but few published studies have discussed predictors of the survival outcome.A Boolean search of the PubMed, Embase, and OVID databases was conducted by 2 investigators independently. The objects were intramedullary grade II ependymoma according to 2007 WHO classification. Univariate Kaplan–Meier analysis and Log-Rank tests were performed to identify variables associated with progression-free survival (PFS) or overall survival (OS). Multivariate Cox regression was performed to assess hazard ratios (HRs) with 95% confidence intervals (95% CIs). Statistical analysis was performed by SPSS version 23.0 (IBM Corp.) with statistical significance defined as P < .05.A total of 35 studies were identified, including 169 cases of CE. The mean follow-up time across cases was 64.2 ± 51.5 months. Univariate analysis showed that patients who had undergone total resection (TR) had better PFS and OS than those with subtotal resection (STR) and biopsy (P = .002, P = .004, respectively). Within either univariate or multivariate analysis (P = .000, P = .07, respectively), histological type was an independent prognostic factor for PFS of CE [papillary type: HR 0.002, 95% CI (0.000–0.073), P = .001, tanycytic type: HR 0.010, 95% CI (0.000–0.218), P = .003].It was the first integrative analysis of CE to elucidate the correlation between kinds of factors and prognostic outcomes. Definite histological type and safely TR were foundation of CE's management.Level of Evidence: 4

show abstract

“…It is associated with better long-term control, OS, and PFS when compared to STR. 22,23 If possible, en bloc resection is preferable to piecemeal resection, as tumor capsule NeuroOncology Neuro-Oncology Practice violation has been reported to increase the risk of CSF seeding and metastasis, while GTR without tumor capsule violation may be curative. 19,24 Despite its extramedullary location and benign grade, MPE carries a long-term prognosis similar to that of WHO grade II ependymoma, perhaps because of a lower overall GTR rate.…”

Section: Intramedullary Spinal Cord Ependymomamentioning

confidence: 99%

Case-based review: ependymomas in adults

Cachia

Johnson

Kaufmann

et al. 2018

Neuro-Oncology Practice

View full text Add to dashboard Cite

Ependymomas are rare primary central nervous system (CNS) tumors in adults. They occur most commonly in the spinal cord, and have classically been graded histologically into World Health Organization (WHO) grades I, II, or III based on the level of anaplasia. Recent data are showing that genetic heterogeneity occurs within the same histological subgroup and that ependymomas arising from different CNS locations have different molecular signatures. This has renewed interest in developing targeting therapies based on molecular profiles especially given the variable outcomes with radiation and the poor results with cytotoxic agents. In this paper, we present the case of a 46-year-old woman with a classic presentation of spinal cord ependymoma and discuss the current histopathological and molecular classification for ependymomas as well as current guidelines for patient management.

show abstract

Predictors of survival in patients with spinal ependymoma

Abstract: We found that lower grade histology and higher extent of surgical resection were significant prognostic factors for more favourable survival outcomes for spinal ependymoma patients.

Cited by 40 publications

References 21 publications

Myxopapillary ependymoma: a SEER analysis of epidemiology and outcomes

Myxopapillary ependymoma: a SEER analysis of epidemiology and outcomes

Outcome predictors in the management of intramedullary classic ependymoma

Case-based review: ependymomas in adults

Contact Info

Product

Resources

About