Retrospective Study Of Clinic Features And Prognostic Factors In69Ependymoma Cases

Objective: To explore the potential prognostic factors including the clinicalfeatures, treatments, pathologic characteristics. To better evaluate the differentfactors on the patients and choose the best treatment protocols which benefitoptimally.Method: A retrospective study was made about the clinic features,treatment strategies, extent of resection, pathologic classification,postoperative therapy (radiotherapy or chemotherapy)and outcomes of69patients who were treated for intracranial ependymoma in the2nd affiliatedhospital to Hebei medical university from Jan.2002to Jan.2012. CT or MRIexamination was adopted to assess the extent of surgery resection. All thepatient received regular out-patient reexamination in3to6months aftersurgery.After follow up study,5year overall survival rate and progressionfree rate were analyzed and potential prognostic factors were evaluated.Results:69patients were enrolled,38man and31women, with age rangedfrom1to61. The mean age was27,44of them were equal and less than30,the rest25were older than30. The time between the onset of the symptomsand the diagnosis averaged6.9±2.0months.28cases were supratentorial,41cases were infratentorial. Among the patients with ependymoma, all of themunderwent surgery processing.40cases were gross total resection,29caseswere subtotal resection. According to WHO criteria, grade II and grade IIIcases were41and28respectively.5cases died during preoperative period. Inour follow up study,50cases were followed up for3months to108months.Radiotherapy and chemotherapy were applied to55cases and33cases forpost-operative therapeutic treatment respectively.5-year overall survival ratewas56.52%, median survival time was65months.Progression free rate was44.44%. Analysis was performed to test the potential factors of prognosis, including patient characteristics (gender and the age of onset),site of lesion,histological grade, the extent of resection, post-operative treatment(radiotherapy and chemotherapy). Survival analysis was executed to find thepossible effect on5-year overall survival rate and progression free rate. Onlyhistology grade and extent of resection were found to have a statisticallysignificant association with the outcome.Conclusion: Totally tumor resection is the main treatment for intracranialependymoma.The extent of resection and histology grade are two independentprognostic factors. Both maximal removing the tumor and low histology gradepredict longer survival time.