TY - JOUR
T1 - Ependymoma of the Spinal Cord in Children
T2 - A Retrospective French Study
AU - Szathmari, Alexandru
AU - Zerah, Michel
AU - Vinchon, Matthieu
AU - Dufour, Christelle
AU - Gimbert, Edouard
AU - Di Rocco, Federico
AU - Chabaud, Sylvie
AU - Conter, Cecile
AU - Mottolese, Carmine
AU - Frappaz, Didier
N1 - Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2019/6/1
Y1 - 2019/6/1
N2 - Background: Ependymoma is the most frequent spinal tumor in adults but it is rather uncommon in children. The aim of the present study was to retrospectively summarize the clinical and therapeutic experience in the treatment of pediatric spinal ependymomas in France. Methods: In the present retrospective multicenter study, data from patients aged <18 years who had been treated from 2000 to 2010 for spinal ependymomas were collected. Epidemiologic and tumor- and treatment-related data were analyzed. The prognostic factors for progression-free survival (PFS) were assessed. Results: We identified 28 patients (22 males, 6 females). Their median age at surgery was 13.67 years (range, 0.7–17.6). Initial gross total resection (GTR) was achieved in 22 children and subtotal resection (STR) in 6. Histologically, 15 tumors were myxopapillary ependymomas and 11 were grade II and 2 grade III ependymomas. Adjuvant initial radiotherapy (RT) was performed in 6 patients. The median follow-up period was of 40 months (range, 2.3–127.5). The 5-year PFS rate was 51% (95% confidence interval, 26.3%–71.2%), and the overall survival rate was 100%. On univariate analysis, only GTR had a significant influence on PFS (P = 0.0013). A subgroup analysis showed a benefit of RT delivered to patients with GTR; however, RT failed to prevent relapse in the group with initial STR. Conclusions: Our data suggest that initial adjuvant RT might improve PFS after GTR but will not prevent relapse in patients with STR. Further studies are needed to define more specific treatments for the latter group.
AB - Background: Ependymoma is the most frequent spinal tumor in adults but it is rather uncommon in children. The aim of the present study was to retrospectively summarize the clinical and therapeutic experience in the treatment of pediatric spinal ependymomas in France. Methods: In the present retrospective multicenter study, data from patients aged <18 years who had been treated from 2000 to 2010 for spinal ependymomas were collected. Epidemiologic and tumor- and treatment-related data were analyzed. The prognostic factors for progression-free survival (PFS) were assessed. Results: We identified 28 patients (22 males, 6 females). Their median age at surgery was 13.67 years (range, 0.7–17.6). Initial gross total resection (GTR) was achieved in 22 children and subtotal resection (STR) in 6. Histologically, 15 tumors were myxopapillary ependymomas and 11 were grade II and 2 grade III ependymomas. Adjuvant initial radiotherapy (RT) was performed in 6 patients. The median follow-up period was of 40 months (range, 2.3–127.5). The 5-year PFS rate was 51% (95% confidence interval, 26.3%–71.2%), and the overall survival rate was 100%. On univariate analysis, only GTR had a significant influence on PFS (P = 0.0013). A subgroup analysis showed a benefit of RT delivered to patients with GTR; however, RT failed to prevent relapse in the group with initial STR. Conclusions: Our data suggest that initial adjuvant RT might improve PFS after GTR but will not prevent relapse in patients with STR. Further studies are needed to define more specific treatments for the latter group.
KW - Ependymoma in children
KW - Radiation therapy
KW - Spine surgery
UR - http://www.scopus.com/inward/record.url?scp=85064253766&partnerID=8YFLogxK
U2 - 10.1016/j.wneu.2019.03.033
DO - 10.1016/j.wneu.2019.03.033
M3 - Article
C2 - 30877001
AN - SCOPUS:85064253766
SN - 1878-8750
VL - 126
SP - e1035-e1041
JO - World Neurosurgery
JF - World Neurosurgery
ER -