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Review
. 2014 Dec;21(12):2096-101.
doi: 10.1016/j.jocn.2014.05.011. Epub 2014 Jul 15.

Prognosis by tumor location in adults with intracranial ependymomas

Eli T Sayegh  1 , Derick Aranda  2 , Joseph M Kim  2 , Taemin Oh  1 , Andrew T Parsa  1 , Michael C Oh  3
Affiliations
Review

Prognosis by tumor location in adults with intracranial ependymomas

Eli T Sayegh et al. J Clin Neurosci. 2014 Dec.

Abstract

Intracranial ependymomas are rare tumors in adults. Thus, factors affecting prognosis are poorly understood. We performed a study to investigate whether tumor location is an important prognostic factor in adults who undergo surgery for intracranial ependymomas. PubMed was searched to identify studies that reported clinical outcomes in adult patients with intracranial ependymoma. Data were extracted for patient and tumor characteristics, extent of resection, progression-free survival (PFS), and overall survival (OS). Tumors were categorized as supratentorial or infratentorial and extraventricular or intraventricular. Presenting clinical features and tumor characteristics were tabulated. Kaplan-Meier and multivariate Cox regression survival analyses were performed to determine PFS and OS by tumor location. Extent of resection was also analyzed by tumor location. A total of 183 patients were included in the meta-analysis. Patients presented at a mean of 8.2months with a myriad of clinical features. The mean tumor size was 3.38 cm, and 19.3% of tumors were cystic. Supratentorial tumors were most commonly located in the frontal and parietal lobes, and infratentorial tumors in the fourth ventricle. Supratentorial tumors demonstrated significantly poorer PFS (p<0.001) and OS (p=0.003) than infratentorial tumors, despite a higher rate of gross total resection (GTR) for the supratentorial tumors (72.6% versus 42.1%). Extraventricular ependymomas displayed significantly poorer PFS than intraventricular ependymomas (p=0.009). In summary, supratentorial ependymomas have significantly poorer PFS and OS than their infratentorial counterparts, despite being more conducive to GTR, suggesting increased clinical aggressiveness. Extraventricular location is also associated with significantly poorer PFS than intraventricular location.

Keywords: Adults; Ependymoma; Intracranial; Prognosis; Survival; Tumor location.

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Conflict of interest statement

Conflicts of Interest/Disclosures

The authors declare that they have no financial or other conflicts of interest in relation to this research and its publication.

Figures

Fig. 1
Fig. 1
Kaplan–Meier survival analysis of (a) progression-free survival and (b) overall survival for supratentorial versus infratentorial tumor location.
Fig. 1
Fig. 1
Kaplan–Meier survival analysis of (a) progression-free survival and (b) overall survival for supratentorial versus infratentorial tumor location.
Fig. 2
Fig. 2
Kaplan–Meier survival analysis of progression-free survival and (b) overall survival for intracranial ependymomas.
Fig. 2
Fig. 2
Kaplan–Meier survival analysis of progression-free survival and (b) overall survival for intracranial ependymomas.
Fig. 3
Fig. 3
Kaplan–Meier survival analysis of progression-free survival and (b) overall survival for extraventricular versus intraventricular tumor locations.
Fig. 3
Fig. 3
Kaplan–Meier survival analysis of progression-free survival and (b) overall survival for extraventricular versus intraventricular tumor locations.
See this image and copyright information in PMC

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