title: Clinical course of adult patients with ependymoma: results of the Adult Ependymoma Outcomes Project.
abstract: BACKGROUND
  Ependymomas are a rare tumor in adults, and there are limited reports of the clinical course, treatment, and current health status of patients.
  
  
  METHODS
  Patients with ependymoma completed an online survey regarding their diagnosis, treatment course, and current health status. Descriptive statistics were used to report the characteristics and degree of symptom severity. Correlations between demographic and clinical characteristics were explored with univariate analysis.
  
  
  RESULTS
  One hundred eighteen adults participated, and there were more women (n = 68) than men (n = 50). The median age was 48 years (range, 22-77 years). Fifty-nine participants (48%) reported that they had not been able to work since their diagnosis, and 31% reported receiving disability benefits. Patients who had been treated for spine tumors had symptoms longer than those who had been treated for brain lesions (chi-square statistic, 7.294; P = .026), and the majority had 3 symptoms before diagnosis. Most patients reported undergoing complete resection (brain lesions, 62%; spine tumors, 58%), and patients with spine tumors were less likely to have received additional treatment (chi-square statistic, 9.687; P = .008). The majority had not had a recurrence and reported consulting a neurosurgeon for surveillance. Despite having stable disease and not receiving active treatment, most patients described moderate to severe symptoms, including fatigue (44%), numbness/tingling (39%), pain (36%), and disturbed sleep (34%) overall. Brain lesions were associated with altered vision (25%), difficulty concentrating (25%), weakness (19%), irritability (19%), difficulty speaking (19%), and understanding (17%); and spine lesions were associated with extremity weakness (55%), sexual dysfunction (48%), radiating pain (37%), and change in bowel pattern (35%).
  
  
  CONCLUSIONS
  Treatment for adult patients with ependymoma is not standardized. Despite the low recurrence rate, patients reported significant symptoms and disability.
authors.affiliation: University of Texas Health Science Center-Houston School of Nursing, Houston, Texas, USA. terri.s.armstrong@uth.tmc.edu
authors.forename: Terri S
authors.initials: TS
authors.lastname: Armstrong
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Vera-Bolanos
authors.forename: Mark R
authors.initials: MR
authors.lastname: Gilbert
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000628:therapy; D004806:Ependymoma / Q000175:diagnosis* / Q000628:therapy; D005221:Fatigue; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain; D011788:Quality of Life; D012008:Recurrence; D013120:Spinal Cord Neoplasms / Q000175:diagnosis* / Q000628:therapy