Department of Radiation Oncology, The University of Texas, M.D. Anderson Cancer Center, 1515 Holcombe Blvd. Unit 0097, Houston, TX, 77030, USA,
J Neurooncol. 2013 Dec;115(3):513-20. doi: 10.1007/s11060-013-1254-8. Epub 2013 Oct 2.
Observation following gross-total resection (GTR) for non-anaplastic supratentorial ependymomas is often advocated based on small, retrospective series. The purpose of this study is to perform a population-based analysis to examine outcomes for this rare cohort of low-risk patients. A retrospective analysis was conducted utilizing the Surveillance, Epidemiology and End Results Program of the United States National Cancer Institute. We identified patients with supratentorial non-anaplastic ependymoma who underwent GTR alone or GTR followed by radiation. We identified 92 patients who met these criteria. The median age was 17.5 years (range 1-83) with the majority female (58 %) and white (75 %). Radiotherapy (RT) was delivered in half of patients. The 5-/10-year Kaplan-Meier estimated overall survival (OS) and cause-specific survival (CSS) for the overall cohort was 83.2/71.4 and 84.1/78.0 %, respectively. There was no evidence of decreased CSS (HR 0.52 [0.18-1.51]; p = 0.23) or OS (HR 0.63 [0.25-1.59]; p = 0.33) with the omission of RT on univariate analysis. Age ≥18 years correlated with worse OS (HR 4.01 [1.45-11.11]; p = 0.008) and CSS (HR 2.86 [0.99-8.31]; p = 0.05). RT did not impact outcome for this low-risk cohort of patients. Older age correlates with poor prognosis.
非间变幕上室管膜瘤行大体全切除(GTR)后的观察常基于小样本回顾性系列研究。本研究旨在进行一项基于人群的分析,以检查这一低危患者罕见队列的结果。我们利用美国国家癌症研究所的监测、流行病学和最终结果计划进行了回顾性分析。我们确定了仅行 GTR 或 GTR 后行放疗的幕上非间变室管膜瘤患者。我们确定了 92 名符合这些标准的患者。中位年龄为 17.5 岁(范围 1-83 岁),大多数为女性(58%)和白人(75%)。半数患者接受了放疗。全队列的 5 年和 10 年 Kaplan-Meier 估计总生存率(OS)和疾病特异性生存率(CSS)分别为 83.2%/71.4%和 84.1%/78.0%。单因素分析显示,未行放疗并未导致 CSS(HR 0.52 [0.18-1.51];p=0.23)或 OS(HR 0.63 [0.25-1.59];p=0.33)降低。年龄≥18 岁与 OS(HR 4.01 [1.45-11.11];p=0.008)和 CSS(HR 2.86 [0.99-8.31];p=0.05)较差相关。对于这一低危患者队列,放疗并未影响预后。年龄较大与预后不良相关。