TY - JOUR
T1 - Intracranial ependymomas in children
T2 - A critical review of prognostic factors and a plea for cooperation
AU - Bouffet, E.
AU - Perilongo, G.
AU - Canete, A.
AU - Massimino, M.
AU - Bailey, C. C.
AU - Packer, R.
AU - Pierre-Kahn, A.
PY - 1998
Y1 - 1998
N2 - Background. Current controversies in pediatric intracranial ependymoma include histologic categorization and management. Most of our knowledge of this disease comes from single-institution reports. Methods. A literature search was done, covering the period 1976-1996. The aim of this review is to analyze the prognostic factors reported in the literature over the last 20 years. Results. Forty-five series were reviewed, including more than 1,400 children. The largest series reported on 92 patients, and the accrual rate ranged from 0.32-12 patients per year. None of the prognostic factors reported achieved a consensus throughout the different series. Histology remains a major issue, and the range in the incidence of anaplastic ependymo mas (7-89%) highlights the difficulty in agreeing on a histological grading system. The role of surgery on the outcome seems to be determinant. Recent series based on homogeneous imaging-documented extents of resection strongly support the benefit of postoperative radiotherapy. The lack of a proven, effective chemotherapy regimen precludes its use except in prospective pilot studies. Conclusions. Limited information is available from single- institution reports in ependymoma. Only large national or international studies can provide enough information to allow a multivariate analysis of the prognostic factors, and thus lead to new therapeutic proposals.
AB - Background. Current controversies in pediatric intracranial ependymoma include histologic categorization and management. Most of our knowledge of this disease comes from single-institution reports. Methods. A literature search was done, covering the period 1976-1996. The aim of this review is to analyze the prognostic factors reported in the literature over the last 20 years. Results. Forty-five series were reviewed, including more than 1,400 children. The largest series reported on 92 patients, and the accrual rate ranged from 0.32-12 patients per year. None of the prognostic factors reported achieved a consensus throughout the different series. Histology remains a major issue, and the range in the incidence of anaplastic ependymo mas (7-89%) highlights the difficulty in agreeing on a histological grading system. The role of surgery on the outcome seems to be determinant. Recent series based on homogeneous imaging-documented extents of resection strongly support the benefit of postoperative radiotherapy. The lack of a proven, effective chemotherapy regimen precludes its use except in prospective pilot studies. Conclusions. Limited information is available from single- institution reports in ependymoma. Only large national or international studies can provide enough information to allow a multivariate analysis of the prognostic factors, and thus lead to new therapeutic proposals.
KW - Brain tumors
KW - Ependymoma
KW - Prognostic factors
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U2 - 10.1002/(SICI)1096-911X(199806)30:6<319::AID-MPO1>3.0.CO;2-H
DO - 10.1002/(SICI)1096-911X(199806)30:6<319::AID-MPO1>3.0.CO;2-H
M3 - Article
C2 - 9589080
VL - 30
SP - 319
EP - 331
JO - Pediatric Blood and Cancer
JF - Pediatric Blood and Cancer
SN - 1545-5009
IS - 6
ER -