title: Surgical treatment of intraventricular ependymomas and subependymomas.
abstract: OBJECTIVE
  The aim of the study was to present our experience in the surgical treatment of intraventricular ependymomas and subependymomas with special consideration to the evaluation of the surgical outcome and risk of tumour recurrence.
  
  
  METHODS
  We report a series of 36 consecutive patients treated surgically for intraventricular ependymoma or subependymoma in the years 1992-2008. There were 26 lateral ventricle and 10 fourth ventricle tumours. Complete resection was achieved in 19 patients while the remaining 17 patients underwent either subtotal or partial resection. Histopathological evaluation revealed ependymoma, subependymoma and anaplastic ependymoma in 20, 11 and 5 cases, respectively.
  
  
  RESULTS
  Eight patients died after surgery due to postoperative brain injury. Five patients were severely disabled postoperatively: one patient developed hemiparesis, three patients presented adynamic syndrome, and one patient developed severe cerebellar ataxia subsequent to vermis injury. All patients with posterior fossa tumours presented with lower cranial nerve deficit. Seventeen patients received radiotherapy postoperatively. There were five recurrent tumours during follow-up; three patients underwent subsequent reoperation. Importantly, five patients with supratentorial tumours and a history of incomplete resection with postoperative radiotherapy had no tumour recurrence in over 10 years' follow-up.
  
  
  CONCLUSIONS
  Intraventricular ependymomas and subependymomas still remain a surgical challenge due to a relatively high incidence of incomplete tumour resections and/or permanent neurological complications associated with their removal. Still, even incomplete tumour removal with subsequent radiotherapy facilitates long-term progression-free survival in some cases.
authors.affiliation: Klinika Neurochirurgii, Warszawski Uniwersytet Medyczny, Warszawa. arkady.n@wp.pl
authors.forename: Arkadiusz
authors.initials: A
authors.lastname: Nowak
authors.forename: Andrzej
authors.initials: A
authors.lastname: Marchel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D003131:Combined Modality Therapy; D004806:Ependymoma / Q000532:radiotherapy / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011044:Poland; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult