Ependymal tumours in childhood: outcomes and prognostic factors

OBJECTIVES: To retrospectively review the patient demographics, disease profile and treatment outcomes of paediatric patients treated for ependymoma at our institution. STUDY DESIGN AND METHODS: 51 eligible patients were treated between 1980 and 2013. The median age at presentation was 6 years. The majority of patients were male (66,7%), had infratentorial tumours (62,7%) and had low-grade tumours (70,6%). Gross total resection (GTR) was achieved in 22 patients (43,1%). Thirtyeight patients received adjuvant radiotherapy (76,5%) and 10 (19,6%) received adjuvant chemotherapy. RESULTS: The 5-year overall survival (OS) was 63,3 % (median follow up of 46 months). The 5 year progression free survival (PFS) was 50,70%. Seventeen (33,3%) patients experienced treatment failure, of which 13 (76,5%) represented local failure. The median time to first relapse was 20 months. The 5 year PFS for children > 3 was 50,0 % and 27,7% for children ≤ 3 years of age (p = 0.0356). GTR had a superior 5- year OS of 73,9% over subtotal resection with a value of 56,7% (p = 0.0016). Similarly an improved 5-year PFS of 70,3% versus 29,1% was observed with GTR over subtotal resection (p = <0.0001). Patients who received adjuvant radiotherapy (RT) had significantly better outcomes than those in whom RT was not given (p =