Sun Xiang-Yao, Kong Chao, Lu Shi-Bao, Sun Si-Yuan, Guo Ma-Chao, Ding Jun-Zhe
Department of Orthopedics, Xuanwu Hospital Capital Medical University, China; National Clinical Research Center for Geriatric Diseases, China; Capital Medical University, China.
Department of Orthopedics, Xuanwu Hospital Capital Medical University, China; National Clinical Research Center for Geriatric Diseases, China.
J Clin Neurosci. 2018 Nov;57:136-142. doi: 10.1016/j.jocn.2018.08.001. Epub 2018 Aug 23.
This study evaluated survival outcomes of patients with intramedullary Grade II ependymomas and identify prognostic factors. Electronic searches of PubMed, EMBASE, OVID, the Cochrane Central Register of Controlled Trials were performed to identify trials according to the Cochrane Collaboration guidelines. The objects were intramedullary Grade II ependymoma according to 2007 WHO classification. Kaplan-Meier survival analysis with log-rank test was used to analyze progressive free survival (PFS) and overall survival (OS). Cox proportional hazard model was utilized for multivariate analysis with hazard ratio (HR) and 95% confidence interval (CI) calculated. P values <0.05 were considered statistically significant. A total of 28 studies including 138 cases of intramedullary Grade II ependymomas were retrieved. Patients who were classified as cellular ependymomas or papillary ependymomas had higher risks of progression than those who possessed typical Grade II ependymomas. Patients who were treated with adjuvant therapy had a higher risk of progression than those without adjuvant therapy. OS of patients with giant cell ependymoma was significantly shorter than those with typical Grade II ependymoma. Patients who had cellular or papillary subtype, adjuvant therapy would have a shorter estimated value of progression-free time and a higher risk of progression than typical Grade II ependymomas. Giant cell ependymoma patients would have a higher risk of fatality than those with typical Grade II ependymomas. Definite pathology type and appropriate treatments were foundations of intramedullary Grade II ependymomas' managements.
本研究评估了髓内二级室管膜瘤患者的生存结局并确定预后因素。根据Cochrane协作指南，对PubMed、EMBASE、OVID、Cochrane对照试验中央注册库进行电子检索以识别试验。研究对象为根据2007年世界卫生组织分类的髓内二级室管膜瘤。采用Kaplan-Meier生存分析和对数秩检验分析无进展生存期（PFS）和总生存期（OS）。使用Cox比例风险模型进行多变量分析，计算风险比（HR）和95%置信区间（CI）。P值<0.05被认为具有统计学意义。共检索到包括138例髓内二级室管膜瘤患者的28项研究。被归类为细胞型室管膜瘤或乳头状室管膜瘤的患者比具有典型二级室管膜瘤的患者进展风险更高。接受辅助治疗的患者比未接受辅助治疗的患者进展风险更高。巨细胞型室管膜瘤患者的OS明显短于典型二级室管膜瘤患者。具有细胞型或乳头状亚型、接受辅助治疗的患者与典型二级室管膜瘤相比，无进展时间估计值更短且进展风险更高。巨细胞型室管膜瘤患者比典型二级室管膜瘤患者死亡风险更高。明确的病理类型和适当的治疗是髓内二级室管膜瘤管理的基础。
