title: [Intracranial ependymomas in adult patients. Diagnosis and histological prognostic factors].
abstract: BACKGROUND
  Intracranial ependymomas are rare in adults and histopathological prognostic factors are poorly determined.
  
  
  OBJECTIVE
  A retrospective multicentric study was conducted in France in order to assess the prognostic value of histology.
  
  
  METHODS
  Between 1990 and 2004, 216 adult patients with newly diagnosed ependymomas were treated in 19 French centers. Eligibility required institutional histopathological confirmation of an ependymoma and available clinical history and MRI features (see comparison paper).
  
  
  METHODS
  Histological preparations and one paraffin embedded block from each patient were sent to Pr D. Figarella-Branger in Marseille. Central review by four neuropathologists (D. Figarella-Branger, A. Maues de Paula, C. Fernandez and A. Jouvet) was performed. Specimens for which all pathologists agreed with the histological diagnosis of ependymomas were included, whereas cases for which all disagree were excluded and reclassified. In the event of doubt and/or discrepancies between pathologists immunostaining was performed in order to reach a consensus diagnosis. Diagnostic of ependymomas was confirmed in 121 cases (56%). In theses cases, ependymomas were classified according to the WHO system (subtype and grade). The potential prognostic value (overall survival OS and disease free survival DFS) of the following histological parameters was examined: perivascular pseudorosettes, ependymal rosettes, hyalinized vessels, mitotic index, microvascular proliferation, necrosis, area of increased cellularity, nuclear atypia, brain invasion and Mib-1 labelling index.
  
  
  RESULTS
  Among the 121 ependymomas, 88 were grade II (47 classic, 17 cellular, 2 papillar, 6 clear cells and 16 tanicytic) and 33 grade III. WHO grading, occurrence of microvascular proliferation, necrosis, nuclear atypia and high proliferative index were correlated with both OS and DFS. Moreover, quantification of certain parameters enabled a reproducible grading system correlated with both OS and DFS.
authors: Service d'anatomie pathologique et de neuropathologie, hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France. dominique.figarella-branger@medecine.univ-mrs.fr
authors: D
authors: D
authors: Figarella-Branger
authors: P
authors: P
authors: Metellus
authors: M
authors: M
authors: Barrié
authors: A
authors: A
authors: Maues de Paula
authors: C
authors: C
authors: Fernandez
authors: M
authors: M
authors: Polivka
authors: A
authors: A
authors: Vital
authors: F
authors: F
authors: Labrousse
authors: J-M
authors: JM
authors: Vignaud
authors: A
authors: A
authors: Laquerrière
authors: M-C
authors: MC
authors: Rousselet
authors: C
authors: C
authors: Lacroix
authors: S
authors: S
authors: Saikali
authors: F
authors: F
authors: Chapon
authors: M-F
authors: MF
authors: Gontier
authors: F
authors: F
authors: Chrétien
authors: P
authors: P
authors: Babin
authors: V
authors: V
authors: Rigau
authors: F
authors: F
authors: Vandenbos
authors: M
authors: M
authors: Peoc'h
authors: M
authors: M
authors: Kujas
authors: O
authors: O
authors: Chinot
authors: J
authors: J
authors: Gouvernet
authors: R
authors: R
authors: Giorgi
authors: J
authors: J
authors: Guyotat
authors: A
authors: A
authors: Jouvet
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D018450:Disease Progression; D004806:Ependymoma / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D019635:Neurosurgical Procedures; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate