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The histologic grade is a main prognostic factor
for patients with intracranial ependymomas treated in the microneurosurgical
era: an analysis of 258 patients
Korshunov A, Golanov A, Sycheva R, Timirgaz V
Department of Neuropathology, Burdenko Neurosurgical Institute,
Moscow, Russia. akorshunov@nsi.ru
Background. Ependymomas account for 3-5% of all intracranial malignancies
and occur most often in children and young adults. These neoplasms continue to
generate considerable controversy with regard to their rational clinical
management. It has been shown that the histologic classification of ependymoma
is a significant predictor of clinical outcome in patients with
ependymoma.
Methods. Ependymomas
from 258 patients who underwent microsurgery at a single institution were
evaluated histologically to elucidate the prognostic utility of a recently
proposed grading scheme. Pathologic and clinical data then were compared using
univariate and multivariate analyses.
Results.
Increasing grade of
ependymoma malignancy was found to be associated strongly and independently with
worse clinical outcomes in terms of both event-free survival and overall
survival. The effect of radiotherapy also was found to be related to histologic
grade and was more beneficial for patients who had anaplastic ependymomas and
had undergone complete tumor removal.
Conclusions.
The application of a
uniform diagnostic criteria for grading ependymomas highlighted the key role of
tumor histology in clinical outcome in a cohort of patients who were treated in
the microsurgical era. The recently proposed grading scheme is likely to be
practically useful, reproducible, and clinically applicable.
Copyright 2004 American Cancer Society.
PMID: 15022291 [PubMed - indexed for MEDLINE]
Source: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15022291
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