Intracranial Ependymal Tumors: A Clinical Study Of 44 Cases

Objective:To better determine the salient signs and symptoms of patients with an ependymoma; to evaluate the current management strategies and also for exploring the prognostic factors.Meathods:A review was made about the clinical characteristics, management strategies and outcomes of treatment of 44 patients who were treated for intracranial ependymoma in the 2nd affiliated hospital to Zhejiang university college of medicine from Jan.2000 to Jan.2010. And the possible prognostic factors were analyzed.Results:A total of 44 consecutive patients were included, there were 26 men and 18 women, with age ranged from 3 to 63. The mean age was 31.6±18.2years. The time between the onset of the symptoms and the diagnosis averaged 15.2±3.7 months (ranged 7 days to 7 years). The clinical manifestations depend on the location and size of lesions and mostly presented with symptoms of intracranial hypertension or local neurological dysfunction.17 cases were supratentorial,27 cases were infratentorial.30 cases had low grade (WHOI-II) and 14 cases were high-grade (WHOIII) tumors. In the group of supratentorial cases,11 patients were low grade,6 cases were high grade. In the infratentorial group the number is 19 and 8 respectively.30 patients had gross total resection and 14 patients had subtotal resection.16 patients had radiotherapy after surgery.4 cases died after operation, and 36 cases were followed up for 6 months to 7 years with an average of 23.1.±4.7months.The tumor site, the extent of tumor resection and the pathological chassification were analyzed for the effects on prognosis, and the extent of tumor resection was the only fact found to have a statistically significant association with the outcome.Conclusion:The clinical presentations of intracranial ependymomas are nonspecific, and depend on the size, location and malignancy of the tumors. CT and MRI are the initial choice in the diagnosis of intracranial ependymomas. Surgery represents the standard treatment, and the extent of tumor resection is the most important factor affecting the survival time ratio. Extent of tumor resection is positively correlated with the prognosis. While keeping minimal morbidity, every attempt should be made at the initial procedure to resect the tumors completely as possible.