title: Predictors of survival among pediatric and adult ependymoma cases: a study using Surveillance, Epidemiology, and End Results data from 1973 to 2007.
abstract: BACKGROUND
  Despite previous research, prognostic factors for ependymoma remain relatively controversial. The purpose of our study was to examine demographic, clinical, and tumor attributes as potential predictors of survival using Surveillance, Epidemiology, and End Results (SEER) program data (1973-2007).
  
  
  METHODS
  All ependymoma (ICD-O-3 code 9391) and anaplastic ependymoma cases (ICD-O-3 code 9392) with complete data (n = 2,369 and n = 319, respectively) were included from SEER. Predictive Cox regression models were built separately among pediatric and adult cases. Recursive partitioning was used to corroborate results from regression models.
  
  
  RESULTS
  Among pediatric cases, tumor characteristics with a significantly increased mortality risk were anaplastic histology (vs. low grade, HR: 1.51, 95% CI: 1.04-2.19) and infratentorial tumor location (vs. spinal cord, HR: 3.86, 95% CI: 1.17-12.77). Among adults, supratentorial tumors were associated with higher mortality hazard (vs. spinal cord tumors) than infratentorial tumors (HR: 4.83, 95% CI: 3.49-6.68 and HR: 2.41, 95% CI: 1.79-3.25, respectively). Complete surgical resection of the tumor conferred the most protection among pediatric and adult patients.
  
  
  CONCLUSIONS
  Our results indicate that treatment type and tumor characteristics are important prognostic factors in patients with ependymoma. However, there may be key differences between pediatric and adult cases regarding how these factors influence survival.
authors: Dan L. Duncan Cancer Center, Baylor College of Medicine, Baylor College of Medicine, Houston, TX 77030, USA.
authors: E Susan
authors: ES
authors: Amirian
authors: Terri S
authors: TS
authors: Armstrong
authors: Kenneth D
authors: KD
authors: Aldape
authors: Mark R
authors: MR
authors: Gilbert
authors: Michael E
authors: ME
authors: Scheurer
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000401:mortality*; D002648:Child; D002675:Child, Preschool; D004806:Ependymoma / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D018426:SEER Program; D012737:Sex Factors; D013120:Spinal Cord Neoplasms / Q000401:mortality*; D016019:Survival Analysis