A retrospective analysis of recurrent intracranial ependymoma

Reuben Antony, Kenneth E. Wong, Moneil Patel, Arthur J. Olch, Gordon Mccomb, Mark Krieger, Floyd Gilles, Richard Sposto, Anat Erdreich-Epstein, Girish Dhall, Sharon Gardner, Jonathan L. Finlay

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background: Recurrence occurs in almost 50% of patients with intracranial ependymoma, and their outcome following recurrence is poor. Methods: We retrospectively reviewed the medical records of 22 patients with intracranial ependymoma and subsequent relapse(s) (59 recurrences) treated at Children's Hospital Los Angeles or New York University between January 1997 and December 2012. Results: Median duration of follow-up was 52 months (7-171 months). Median age at initial diagnosis was 4 years (0.3-19 years) with 8 patients younger than 3 years at presentation. Eleven patients had anaplastic and 11 cellular pathologies. Eighteen patients had infratentorial tumors at diagnosis and 3 (all infratentorial) had metastatic spinal cord involvement at presentation. Cerebrospinal fluid involvement was not identified at diagnosis or relapse. Median time to first recurrence was 16 months (1.3 to 115 months). The number of recurrences in each patient ranged from 1 to 9 (median=2). Thirty-seven recurrences (63%) were detected asymptomatically by surveillance imaging. Fifteen recurrences (26%) arose outside the initial tumor site. Recurrences were treated by surgical resection (45), with irradiation (30), and with various oral chemotherapies (23) with (7) or without (16) conventional chemotherapy. The 5 and 10 year overall survival rates from first recurrence were 0.37±0.14 and 0.25±0.14. Conclusion: Prolonged (5-10 year) survival from first relapse was noted in over one-quarter of our patients. It remains unclear whether early radiographic diagnosis, differing treatment modalities beyond radical surgical resection or possibly unrecognized biological differences contributed towards this prolonged survival. Pediatr Blood Cancer 2014;61:1195-1201.

Original languageEnglish (US)
Pages (from-to)1195-1201
Number of pages7
JournalPediatric Blood and Cancer
Volume61
Issue number7
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

Fingerprint

Ependymoma
Recurrence
Infratentorial Neoplasms
Drug Therapy
Survival
Los Angeles
Medical Records
Cerebrospinal Fluid
Early Diagnosis
Neoplasms
Spinal Cord
Survival Rate

Keywords

  • Ependymoma
  • Pediatric
  • Recurrent

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

Cite this

Antony, R., Wong, K. E., Patel, M., Olch, A. J., Mccomb, G., Krieger, M., ... Finlay, J. L. (2014). A retrospective analysis of recurrent intracranial ependymoma. Pediatric Blood and Cancer, 61(7), 1195-1201. https://doi.org/10.1002/pbc.24996

A retrospective analysis of recurrent intracranial ependymoma. / Antony, Reuben; Wong, Kenneth E.; Patel, Moneil; Olch, Arthur J.; Mccomb, Gordon; Krieger, Mark; Gilles, Floyd; Sposto, Richard; Erdreich-Epstein, Anat; Dhall, Girish; Gardner, Sharon; Finlay, Jonathan L.

In: Pediatric Blood and Cancer, Vol. 61, No. 7, 01.01.2014, p. 1195-1201.

Research output: Contribution to journalArticle

Antony, R, Wong, KE, Patel, M, Olch, AJ, Mccomb, G, Krieger, M, Gilles, F, Sposto, R, Erdreich-Epstein, A, Dhall, G, Gardner, S & Finlay, JL 2014, 'A retrospective analysis of recurrent intracranial ependymoma', Pediatric Blood and Cancer, vol. 61, no. 7, pp. 1195-1201. https://doi.org/10.1002/pbc.24996
Antony R, Wong KE, Patel M, Olch AJ, Mccomb G, Krieger M et al. A retrospective analysis of recurrent intracranial ependymoma. Pediatric Blood and Cancer. 2014 Jan 1;61(7):1195-1201. https://doi.org/10.1002/pbc.24996
Antony, Reuben ; Wong, Kenneth E. ; Patel, Moneil ; Olch, Arthur J. ; Mccomb, Gordon ; Krieger, Mark ; Gilles, Floyd ; Sposto, Richard ; Erdreich-Epstein, Anat ; Dhall, Girish ; Gardner, Sharon ; Finlay, Jonathan L. / A retrospective analysis of recurrent intracranial ependymoma. In: Pediatric Blood and Cancer. 2014 ; Vol. 61, No. 7. pp. 1195-1201.
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abstract = "Background: Recurrence occurs in almost 50{\%} of patients with intracranial ependymoma, and their outcome following recurrence is poor. Methods: We retrospectively reviewed the medical records of 22 patients with intracranial ependymoma and subsequent relapse(s) (59 recurrences) treated at Children's Hospital Los Angeles or New York University between January 1997 and December 2012. Results: Median duration of follow-up was 52 months (7-171 months). Median age at initial diagnosis was 4 years (0.3-19 years) with 8 patients younger than 3 years at presentation. Eleven patients had anaplastic and 11 cellular pathologies. Eighteen patients had infratentorial tumors at diagnosis and 3 (all infratentorial) had metastatic spinal cord involvement at presentation. Cerebrospinal fluid involvement was not identified at diagnosis or relapse. Median time to first recurrence was 16 months (1.3 to 115 months). The number of recurrences in each patient ranged from 1 to 9 (median=2). Thirty-seven recurrences (63{\%}) were detected asymptomatically by surveillance imaging. Fifteen recurrences (26{\%}) arose outside the initial tumor site. Recurrences were treated by surgical resection (45), with irradiation (30), and with various oral chemotherapies (23) with (7) or without (16) conventional chemotherapy. The 5 and 10 year overall survival rates from first recurrence were 0.37±0.14 and 0.25±0.14. Conclusion: Prolonged (5-10 year) survival from first relapse was noted in over one-quarter of our patients. It remains unclear whether early radiographic diagnosis, differing treatment modalities beyond radical surgical resection or possibly unrecognized biological differences contributed towards this prolonged survival. Pediatr Blood Cancer 2014;61:1195-1201.",
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AU - Gilles, Floyd

AU - Sposto, Richard

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N2 - Background: Recurrence occurs in almost 50% of patients with intracranial ependymoma, and their outcome following recurrence is poor. Methods: We retrospectively reviewed the medical records of 22 patients with intracranial ependymoma and subsequent relapse(s) (59 recurrences) treated at Children's Hospital Los Angeles or New York University between January 1997 and December 2012. Results: Median duration of follow-up was 52 months (7-171 months). Median age at initial diagnosis was 4 years (0.3-19 years) with 8 patients younger than 3 years at presentation. Eleven patients had anaplastic and 11 cellular pathologies. Eighteen patients had infratentorial tumors at diagnosis and 3 (all infratentorial) had metastatic spinal cord involvement at presentation. Cerebrospinal fluid involvement was not identified at diagnosis or relapse. Median time to first recurrence was 16 months (1.3 to 115 months). The number of recurrences in each patient ranged from 1 to 9 (median=2). Thirty-seven recurrences (63%) were detected asymptomatically by surveillance imaging. Fifteen recurrences (26%) arose outside the initial tumor site. Recurrences were treated by surgical resection (45), with irradiation (30), and with various oral chemotherapies (23) with (7) or without (16) conventional chemotherapy. The 5 and 10 year overall survival rates from first recurrence were 0.37±0.14 and 0.25±0.14. Conclusion: Prolonged (5-10 year) survival from first relapse was noted in over one-quarter of our patients. It remains unclear whether early radiographic diagnosis, differing treatment modalities beyond radical surgical resection or possibly unrecognized biological differences contributed towards this prolonged survival. Pediatr Blood Cancer 2014;61:1195-1201.

AB - Background: Recurrence occurs in almost 50% of patients with intracranial ependymoma, and their outcome following recurrence is poor. Methods: We retrospectively reviewed the medical records of 22 patients with intracranial ependymoma and subsequent relapse(s) (59 recurrences) treated at Children's Hospital Los Angeles or New York University between January 1997 and December 2012. Results: Median duration of follow-up was 52 months (7-171 months). Median age at initial diagnosis was 4 years (0.3-19 years) with 8 patients younger than 3 years at presentation. Eleven patients had anaplastic and 11 cellular pathologies. Eighteen patients had infratentorial tumors at diagnosis and 3 (all infratentorial) had metastatic spinal cord involvement at presentation. Cerebrospinal fluid involvement was not identified at diagnosis or relapse. Median time to first recurrence was 16 months (1.3 to 115 months). The number of recurrences in each patient ranged from 1 to 9 (median=2). Thirty-seven recurrences (63%) were detected asymptomatically by surveillance imaging. Fifteen recurrences (26%) arose outside the initial tumor site. Recurrences were treated by surgical resection (45), with irradiation (30), and with various oral chemotherapies (23) with (7) or without (16) conventional chemotherapy. The 5 and 10 year overall survival rates from first recurrence were 0.37±0.14 and 0.25±0.14. Conclusion: Prolonged (5-10 year) survival from first relapse was noted in over one-quarter of our patients. It remains unclear whether early radiographic diagnosis, differing treatment modalities beyond radical surgical resection or possibly unrecognized biological differences contributed towards this prolonged survival. Pediatr Blood Cancer 2014;61:1195-1201.

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