Pediatric Spinal Ependymomas: An Epidemiological Study.

Pediatric Spinal Ependymomas: An Epidemiological Study.

World Neurosurg. 2018 Apr 06;:

Authors: Khalid SI, Kelly R, Adogwa O, Carlton A, Woodward J, Ahmed S, Khanna R, Bagley C, Cheng J, Shah S, Mehta AI

Abstract
OBJECTIVE: Pediatric intramedullary spinal cord ependymomas represent a rare central nervous system neoplasm with little available data regarding incidence and outcomes. To this end, large population-based studies are needed to assess the epidemiology and survival risk factors associated with these tumors in the hope of better understanding these tumors as well as improving outcomes. The authors undertook this retrospective study to explore factors that may influence survival in pediatric patients with intramedullary spinal cord ependymomas.
METHODS: Utilizing the Surveillance, Epidemiology, and End Results (SEER) database, a prospective cancer registry, the authors retrospectively assessed survival in histologically confirmed spinal ependymomas in patients 17 years of age and younger. Survival was described with Kaplan-Meier curves, and a multivariate regression analysis was used to assess the association of several variables with survival while controlling for confounding variables.
RESULTS: Invasive tumor extension (p <0.001) was associated with decreased survival while gross total resection (p =0.028) correlated with better rates of survival. Age, gender, tumor size, tumor extension, the utilization and sequence of radiation therapy, or utilization of chemotherapy were not found to have a statistically significant association with survival outcomes.
CONCLUSIONS: Invasive ependymomas occurring in the spine have a much worse prognosis, while higher tumor grades do not clearly demonstrate worse rates of survival. Early diagnosis and surgery appear to be associated with improved survival and outcomes, while radiation therapy and chemotherapy has an unclear role.

PMID: 29631082 [PubMed - as supplied by publisher]

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