[Brain tumors in infants and children--factors affecting prognosis. (Part 1) Ependymoma (author's transl)].
Ependymomas constitute 6.1 to 12.7 percent of pediatric intracranial neoplasms with a predominance of male patients, younger children and infratentorial involvement. Although there is a generally accepted pathological classification of ependymoma, the prognosis and surgical results of this tumor do not always correlate with the apparent tumor malignancy. We analyzed 38 ependymomas in children in light of the prognosis and its affecting factors. Thirty-three were intracranial and 5 were intraspinal. Among 33 intracranial ependymomas, 20 were infratentorial (4th ventricle) 9 were in the lateral ventricle or cerebral parenchyma and 4 were in the para third ventricular region. In age distribution, 3rd or 4th ventricular ependymomas were seen in younger children, under the age of 10 years, except for one child; while ependymomas in the lateral ventricle, cerebral parenchyma or spinal cord were more common in older children. Malignant ependymomas or ependymoblastomas were found in 14 intracranial ependymomas involving equally each location. The surgical mortality in 38 ependymomas was 0. The five year survival rates in malignat ependymomas and low grade ependymomas were not significantly different. However, the five year survivals in the 3rd or 4th ventricular ependymomas were extremely poor, 20% and 0% respectively, while lateral ventricular or intraparenchymal ependymomas had an excellent survival rate of 60% at five years. The patients with total tumor removal survived significantly longer (5 year survival 50%) than with subtotal resection (5 year survival 25.5%) or biopsy (5 year survival 16.6%). All patients except 4 were treated with radiation therapy. The clinical significance of radiation therapy will also be further discussed.
D002551:Cerebral Ventricle Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D002552:Cerebral Ventricles / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D004806:Ependymoma / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D006801:Humans; D007223:Infant; D011379:Prognosis