Treatment and survival of supratentorial and posterior fossa ependymomas in adults

Miriam Nuño, Jeffrey J. Yu, Kunal Varshneya, Julia Alexander, Debraj Mukherjee, Keith L. Black, Chirag G. Patil

Research output: Contribution to journalArticle

Abstract

Ependymoma is a rare primary brain or spinal cord tumor that arises from the ependyma, a tissue of the central nervous system. This study analyzed a large cohort of adult supratentorial and posterior fossa ependymoma tumors in order to elucidate factors associated with overall survival. We utilized the USA National Cancer Database to study adult World Health Organization grade II/III supratentorial and posterior fossa ependymoma patients treated between 1998 and 2011. Overall survival was estimated by the Kaplan-Meier method and factors associated with survival were determined using a multivariate Cox proportional hazards model. Among 1318 patients, 1055 (80.0%) had grade II and 263 (20.0%) anaplastic tumors located in the posterior fossa (64.3%) and supratentorial region (35.7%). Overall average age was 44.3 years, 48.0% of patients were female, 86.5% were Caucasian, and 36.8% underwent near/gross total surgical resection. Radiotherapy was given to 662 patients (50.8%) and 75 (5.9%) received chemotherapy. Older age at diagnosis (hazard ratio [HR] 1.51, p < 0.0001), high tumor grade (HR 1.82, p = 0.005), and large tumor size (HR 1.66, p = 0.008) were associated with poor survival. Females compared to males (HR 0.67, p = 0.03) and patients with posterior fossa tumors versus supratentorial (HR 0.64, p = 0.04) had a survival advantage. Our study showed that older patients, with supratentorial tumors, and high histological grade had an increased risk of mortality. A survival benefit was captured in females and patients with posterior fossa tumors. Adjuvant radiotherapy and chemotherapy did not confer a survival benefit among all patients, even after stratification by tumor grade or anatomical location.

Original languageEnglish (US)
Pages (from-to)24-30
Number of pages7
JournalJournal of Clinical Neuroscience
Volume28
DOIs
StatePublished - Jun 1 2016
Externally publishedYes

Fingerprint

Ependymoma
Survival
Infratentorial Neoplasms
Therapeutics
Neoplasms
Supratentorial Neoplasms
Ependyma
Spinal Cord Neoplasms
Adjuvant Radiotherapy
Adjuvant Chemotherapy
Proportional Hazards Models
Radiotherapy
Central Nervous System
Databases
Drug Therapy
Mortality
Brain

Keywords

  • Chemotherapy
  • Ependymomas
  • Overall survival
  • Posterior fossa
  • Radiotherapy
  • Supratentorial

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Physiology (medical)

Cite this

Treatment and survival of supratentorial and posterior fossa ependymomas in adults. / Nuño, Miriam; Yu, Jeffrey J.; Varshneya, Kunal; Alexander, Julia; Mukherjee, Debraj; Black, Keith L.; Patil, Chirag G.

In: Journal of Clinical Neuroscience, Vol. 28, 01.06.2016, p. 24-30.

Research output: Contribution to journalArticle

Nuño, Miriam ; Yu, Jeffrey J. ; Varshneya, Kunal ; Alexander, Julia ; Mukherjee, Debraj ; Black, Keith L. ; Patil, Chirag G. / Treatment and survival of supratentorial and posterior fossa ependymomas in adults. In: Journal of Clinical Neuroscience. 2016 ; Vol. 28. pp. 24-30.
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