|
|
Multivariate Analysis of Clinical
Prognostic Factors in Children with Intracranial Ependymomas
Tang-Her Jaing, Huei-Shyong Wang, Pei-Kwei Tsay,
Chen-Kan Tseng, Shih-Ming Jung, Kuang-Lin Lin, Tai-Ngar Lui
Division of Hematology and Oncology, Department of
Pediatrics, Chang Gung Children's Hospital, Taoyuan, Taiwan (T.-H.J.);
Division of Neurology, Department of Pediatrics, Chang
Gung Children's Hospital, Kwei-Shan 333, Taoyuan, Taiwan (H.-S.W.,
K.-L.L.); Department of Public Health and Center of
Biostatistics, College of Medicine, Chang Gung University, Taoyuan, Taiwan
(P.-K.T.);
Department of Radiation Oncology, Chang Gung Memorial
Hospital, Taoyuan, Taiwan (C.-K.T.);
Department of Pathology, Chang Gung Memorial Hospital,
Taoyuan, Taiwan (S.-M.J.);
Division of Neurosurgery, Department of Surgery, Chang
Gung Memorial Hospital, Taoyuan, Taiwan (T.-N.L)
The optimal postoperative management of pediatric intracranial
ependymomas is controversial.
We analyzed clinical prognostic factors for their influence on outcome in such
children.
Our retrospective series included 15 with supratentorial and 28 with
infratentorial tumors.
Twenty ependymomas were grade II, and 23 were anaplastic.
Complete resection was performed in 18 patients, incomplete resection in 19, and
stereotactic biopsy in 6.
Radiotherapy was done in 31 patients and chemotherapy in 13.
The surviving patients have been followed 8–232
months (median: 69 months).
The median survival time was 30 months, and 5-year overall survival and
progression-free survival rates were 53.9% and 45.9%, respectively.
By tumor site: supratentorial, 56.6% and 50.9%; infratentorial, 52.3% and
42.5%.
Multivariate analysis identified complete resection (5-year progression-free
survival, 71.8%) and age <3 years old as significant favorable and adverse
prognostic features (relative risk, 2.59; 95% CI, 1.05–6.38),
respectively.
Twenty-six children relapsed 1–107 months after
diagnosis (median: 12 months).
Relapses were local in 22 cases, and combined local and distant in three
cases.
Only one of 15 patients with supratentorial tumors developed isolated spinal
metastasis.
Failure at the primary site is the major obstacle to improve cure rates.
The extent of surgical resection and age were the only statistically significant
prognostic factors.
Keywords: chemotherapy, children, intracranial ependymoma, radiotherapy, survival
Copyright
©
2004 Kluwer Academic Publishers.
All rights reserved
Source: http://ipsapp009.kluweronline.com/IPS/content/ext/x/J/5042/I/119/A/9/abstract.htm
|
