Dan L. Duncan Cancer Center, Baylor College of Medicine, Baylor College of Medicine, Houston, TX 77030, USA.
Neuroepidemiology. 2012;39(2):116-24. doi: 10.1159/000339320. Epub 2012 Jul 28.
Despite previous research, prognostic factors for ependymoma remain relatively controversial. The purpose of our study was to examine demographic, clinical, and tumor attributes as potential predictors of survival using Surveillance, Epidemiology, and End Results (SEER) program data (1973-2007).
All ependymoma (ICD-O-3 code 9391) and anaplastic ependymoma cases (ICD-O-3 code 9392) with complete data (n = 2,369 and n = 319, respectively) were included from SEER. Predictive Cox regression models were built separately among pediatric and adult cases. Recursive partitioning was used to corroborate results from regression models.
Among pediatric cases, tumor characteristics with a significantly increased mortality risk were anaplastic histology (vs. low grade, HR: 1.51, 95% CI: 1.04-2.19) and infratentorial tumor location (vs. spinal cord, HR: 3.86, 95% CI: 1.17-12.77). Among adults, supratentorial tumors were associated with higher mortality hazard (vs. spinal cord tumors) than infratentorial tumors (HR: 4.83, 95% CI: 3.49-6.68 and HR: 2.41, 95% CI: 1.79-3.25, respectively). Complete surgical resection of the tumor conferred the most protection among pediatric and adult patients.
Our results indicate that treatment type and tumor characteristics are important prognostic factors in patients with ependymoma. However, there may be key differences between pediatric and adult cases regarding how these factors influence survival.
尽管已有先前的研究，但影响室管膜瘤预后的因素仍存在较大争议。本研究旨在利用监测、流行病学和最终结果（SEER）计划数据（1973-2007 年），通过检查人口统计学、临床和肿瘤特征，来确定这些特征是否能作为生存的预测指标。
SEER 数据库中纳入所有具有完整数据的室管膜瘤（ICD-O-3 编码 9391）和间变室管膜瘤（ICD-O-3 编码 9392）病例（分别为 n=2369 和 n=319）。在儿科和成人病例中分别建立预测性 Cox 回归模型，递归分区用于验证回归模型的结果。
在儿科病例中，组织学分级为间变（相对于低级别，HR：1.51，95%CI：1.04-2.19）和肿瘤位于小脑幕下（相对于脊髓，HR：3.86，95%CI：1.17-12.77）与死亡率显著增加相关。在成人中，与幕下肿瘤相比，幕上肿瘤与更高的死亡风险相关（相对于脊髓肿瘤，HR：4.83，95%CI：3.49-6.68 和 HR：2.41，95%CI：1.79-3.25）。对于儿科和成人患者，肿瘤完全切除是最有效的治疗方式。
本研究结果表明，治疗类型和肿瘤特征是影响室管膜瘤患者预后的重要因素。然而，在这些因素如何影响生存方面，儿科和成人病例之间可能存在关键差异。
