Clinical characteristics and prognostic factors of intracranial ependymoma in children / 中华实用儿科临床杂志

ABSTRACT

Objective:To investigate the clinical features, diagnosis, treatment and prognostic factors of intracranial ependymoma in children.Methods:The clinical data of 32 children with intracranial ependymoma treated in the Department of Neurosurgery, Beijing Children′s Hospital of Capital Medical University from January 2012 to December 2020 were retrospectively analyzed.There were 23 males and 9 females.The median age of diagnosis was 4.5 years old (0.7-10.0 years old). Twelve cases (37.5%) were less than 3 years old and 20 cases (62.5%) were more than 3 years old.Tumors were supratentorial in 14 cases and infratentorial in 18 cases.All patients underwent tumor resection.Eighteen cases received postoperative radiotherapy, and 20 cases received chemotherapy.Four cases took neither radiotherapy nor chemotherapy. Kaplan- Meier method was used to establish the survival curve the intracranial ependymoma patients.Whether the difference of a single variable was significant was examined by the Log- rank test. Results:Of the 32 patients, 30 cases underwent gross total resection and 2 underwent subtotal resection.The mean follow-up time was 24 months (1-62 months). By the time of the last follow-up, 26 cases survived and 6 cases died.The 1-year and 3-year survival rates were 88% and 78%, respectively.Univariate analysis showed that the tumor location ( OR=1.5, 95% CI: 1.082-2.079, P=0.040) greatly affected the overall survival time in children with intracranial ependymoma, and chemotherapy ( OR=0.5, 95% CI: 0.125-1.999, P=0.034) had significant impact on the overall survival time of patients younger than 3 years old. Conclusions:Intracranial ependymoma is more prone to occur in the infratentorial region than the supratentorial region.The tumor location is an important factor affecting the survival of children with ependymoma.For children younger than 3 years old, postoperative chemotherapy can well improve the prognosis, but cannot change the progress of the disease development.