Format

Send to

Choose Destination
J Clin Neurosci. 2017 Dec;46:72-78. doi: 10.1016/j.jocn.2017.08.056. Epub 2017 Sep 8.

Recursive partitioning analysis for disease progression in adult intracranial ependymoma patients.

Author information

1
Department of Neurosurgery, Konkuk University College of Medicine, Konkuk University Medical Center, Seoul, Republic of Korea.
2
Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
3
Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
4
Department of Pathology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
5
Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
6
Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
7
Department of Neurology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
8
Department of Radiation Oncology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
9
Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea. Electronic address: nslee@snu.ac.kr.
10
Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea. Electronic address: nsckpark@snu.ac.kr.

Abstract

Intracranial ependymomas are rare tumors in adults. Although recent advancements from demographic, clinical, and biological studies provide new perspectives on this rare tumor, they are not yet widely applied in clinical practice. Currently, most ependymoma patients are treated in the same way: via surgical resection with adjuvant radiation therapy. However, it is reasonable to apply more aggressive treatment for high-risk patients. From this point of view, we performed a study to investigate risk grouping for disease progression of intracranial ependymomas in adults. A total of 53 patients were included in this study. Data were extracted for patient and tumor characteristics, extent of resection, progression-free survival (PFS), and overall survival. Prognostic variables from univariate and multivariate survival analyses were included in a recursive partitioning analysis for the hierarchical risk grouping of the estimated PFS. Three risk groups were defined based on the clinical prognostic factors. Survival analysis showed significant differences in mean PFS between the different groups: 160.5±22.1months in the complete resection group, 100.4±36.8months in the incomplete-resection and intraventricular-location group, and 23.5±6.9months in the incomplete-resection and extraventricular-location group (p<0.001). The risk of disease progression in adult intracranial ependymoma patients could be stratified by degree of resection and tumor location. In clinical practice, this result could provide useful information, such as when "second-look" surgery should be performed or whether small tumors invading the fourth ventricle floor should be resected at the expense of neurological deficit.

KEYWORDS:

Disease progression; Ependymoma; Prognosis; Second look surgery

PMID:
28890044
DOI:
10.1016/j.jocn.2017.08.056
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center