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KMID : 0942820120110010003
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Journal of Korean Brain Tumor Society
2012 Volume.11 No. 1 p.3 ~ p.8
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Clinical Outcome and Prognostic Factors of Intracranial Ependymoma
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Lee Su-Heon
Cha Seung-Heon
Nam Kyoung-Hyup
Cho Won-Ho
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Abstract
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Objective: Ependymomas are infrequently seen tumors that have been defined as neoplasm arising from ependymal cells lining the ventricles and the central canal of the spinal cord. As prognostic factor, histological features and surgical resection and the efficacy of prophylactic radiation remain controversial in the management of intracranial ependymoma. We analyzed a series of patients with intracranial ependymoma to review our strategy of treatment and prognostic factor.
Materials and Methods: Between Jan 2001 and Dec 2008, 11 patients have been under treatment at our institute. Seven cases involved Grade II lesion according to the World Health Organization (WHO) classification of ependymoma, and four cases involved Grade III lesion. Postoperative radiation was performed in eight cases and chemotherapy was administered in three childhood patients. We analyzed the result of treatment and prognosis according to recurrence of tumor.
Results: Overall recurrence rates were significantly lower in patients with Grade II ependymoma and in patients who had undergone gross total resection of the tumor. Three patients (27.3%) revealed progression or recurrence from 12 to 65 months (median 29.7 months) after diagnosis. In two patients, the ependymoma recurred only at the original tumor site. One patients experienced both local and distant relapse as spinal seeding. Histologic grade and extent of resection were related with tumor recurrence or progression. Among eight cases underwent adjuvant radiotherapy (Five cases of Grade II, Three cases of Grade III), three cases of Grade III revealed tumor progression and none of Grade II cases showed tumor progression.
Conclusion: Histologic grade is the important prognostic factor with respect to patient survival, tumor recurrence and tumor progression. Although there was no statistical significance, progression rate is higher in young age and infratentorial tumors. Grade III ependymoma is more common in young age and infratentorial area.
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KEYWORD
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Adjuvant treatment, Clinical outcome, Histologic feature, Intracranial ependymoma, Prognostic
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