Treatment of pediatric Grade II spinal ependymomas: a population-based study

Abstract

<jats:sec> <jats:title>OBJECT</jats:title> <jats:p>Grade II spinal cord ependymomas occurring in pediatric patients are exceptionally rare neoplasms. In this paper the authors use a national cancer database to determine patient demographics, treatment patterns, and associated outcomes of this cohort.</jats:p></jats:sec> <jats:sec> <jats:title>METHODS</jats:title> <jats:p>The Surveillance Epidemiology and End Results (SEER) database was used to analyze subjects younger than 18 years with histologically confirmed diagnoses of Grade II spinal cord ependymoma from the years 1973 to 2008. Descriptive data on the demographic characteristics of this cohort and the associated treatment patterns are shown. The Kaplan-Meier method was used to estimate overall survival at 1, 2, 5, and 10 years.</jats:p></jats:sec> <jats:sec> <jats:title>RESULTS</jats:title> <jats:p>This cohort comprised 64 pediatric subjects with Grade II spinal ependymoma. The median age was 13 years, nearly half of the patients were male, and most were white (84%). The median follow-up was 9.2 years. Overall survival at 5 and 10 years was 86% and 83%, respectively. Gross-total resection was achieved in 57% of subjects, and radiation therapy was administered to 36%. Radiation therapy was administered to 78% of subjects after subtotal resection but only to 19% of patients after gross-total resection; this difference was significant (p &lt; 0.001). In a multivariate regression model analyzing sex, age at diagnosis, year of diagnosis, radiotherapy, and extent of resection, female sex was found to be an independent predictor of decreased mortality (HR 0.15 [95% CI 0.02–0.94], p = 0.04).</jats:p></jats:sec> <jats:sec> <jats:title>CONCLUSIONS</jats:title> <jats:p>These data show long-term outcomes for pediatric patients with Grade II spinal ependymoma. Radiotherapy was more likely to be administered in cases of subtotal resection than in cases of gross-total resection. Female sex is associated with decreased mortality, while other demographic or treatment modalities are not.</jats:p></jats:sec>

Surgical management of intradural spinal cord tumors in children and young adults: A single-center experience with 50 patients

“…[ 7 ] Therefore, IMSCTs are potentially excisable lesions, both at presentation and if they recur. [ 2 6 7 8 9 11 14 16 23 26 30 31 ] The treatment management of primary malignant spinal cord astrocytomas is not clearly determined in the current literature, neither for children nor in adults. [ 6 7 40 ]…”

Glioblastoma in the setting of prior lower grade gliomas - insights from SEER database

“…The SEER-18 registry (including Hurricane Katrina impacted Louisiana) was queried for patients with glioblastomas and its variants (ICD-O-3 histology codes 9440/3 – glioblastoma NOS, 9441/3 - giant cell glioblastoma, and 9442/3 - gliosarcoma) diagnosed from 1973 to 2013 [ 13 – 15 ]; this group will collectively be defined as GBs in this paper. The patients were further classified into two GB groups: Group A (reference group) – those with GB as the only primary tumor, and Group B – those with GB as a 2 nd primary or subsequent tumor (defined per sequence coding) and with history of lower grade gliomas (presence of prior ICD-O-3 histology codes: 9380 glioma, 9381 gliomatosis, 9382 mixed glioma, 9383 subependymoma, 9384 SEGA, 9391-9394 ependymoma, 9400-9401 astrocytoma, 9410 protoplasmic astrocytoma, 9411 gemistocytic astrocytoma, 9412 desmoplastic infantile astrocytoma, 9420 fibrilillary astrocytoma, 9421 pilocytic astrocytoma, 9424 pleomorphic xanthoastrocytoma, 9444 chondroid glioma, and/or 9450-9451 oligodendroglioma]).…”

“…Only cases with microscopically confirmed / actively followed/ known age / within research database were considered; death certificate only/ autopsy only / alive with no survival time were excluded [ 13 – 15 ]. Age, gender, race, marital status, sequence of diagnosis relative to other primary tumors, occurrence and extent of surgery, tumor size, receipt of radiation, and follow-up data were acquired.…”

“…With the SEER * Stat software, the following calculations were conducted for these two sequence groups A and B [ 13 – 15 ]: 1) incidence rates (per 100,000 person-years) by age groups and 2) incidence rates by year from 2000-2013.…”

“…Occurrence of surgery was defined as such [ 13 – 15 ]: “No surgery” – those coded as “no surgery (00)” OR “Surgery” – those coded as local tumor destruction NOS (10), biopsy (20), surgery NOS (90), partial resection NOS (40), and subtotal resection (21), gross total resection (55), or radical, total, gross total resection (30). Of those who underwent surgery, the extent of primary surgery was defined as follows, similar to previously described [ 13 – 15 ]: “No GTR” – those coded as “local tumor destruction NOS (10), biopsy (20), partial resection NOS (40), and subtotal resection (21)” OR “GTR” – those coded as gross total resection (55) or radical, total, gross total resection (30). “Surgery status unknown” – those coded as surgery, unknown (99) – and surgery NOS (90) was not included in the extent of resection analysis.…”