Snider CA, et al. - This population-based study was performed to investigate the effect of radiation therapy (RT) and gross total resection (GTR) for ependymoma in young children. In patients within 0–3 years of age, ependymoma outcomes significantly improved with RT and GTR. No prognostic significance was observed with the histopathologic grading of ependymoma. Future prospective studies with molecular-based stratification needed to be performed to assess additional prognostic factors because of the poor overall survival (OS) for this population and unique genetic profile.

Methods

• The prognostic factors and treatment outcomes were characterized of 482 patients (0-3 years) with the diagnosis of ependymoma identified from the Surveillance, Epidemiology, and End Results registry (1973-2013).

Results

• In this study, 52.3% of patients underwent RT, and gross total resection (GTR) was performed in 51.0% of patients.
• With median follow-up of 3.3 years, overall survival (OS) at 10 years was 48.4%.
• WHO grade was not predictive of OS.
• For survival, the extent of resection was significant.
• The 10-year OS with GTR was 61.0%, and with subtotal resection (STR) and biopsy was 38.2% and 35.0%, respectively (P < 0.001).
• For both grades II and III, RT significantly benefitted OS.
• With RT, the 10-year OS for grade II was 50.5% and 43.4% without RT (P=0.030).
• For grade III, 10-year OS was 66.0% with RT and 40.0% without (P=0.002).
• The researchers demonstrated significantly improved OS with RT (hazard ratio [HR] 0.601, 95% CI: 0.439-0.820, P=0.001) and GTR (HR 0.471, 95% CI: 0.328-0.677, P < 0.0001) in multivariate analysis.