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Surveillance neuroimaging in childhood intracranial ependymoma: how effective, how often, and for how long?
- Source :
-
Journal of neurosurgery [J Neurosurg] 2001 Jan; Vol. 94 (1), pp. 27-32. - Publication Year :
- 2001
-
Abstract
- Object: The authors examined images obtained in 52 children with intracranial ependymomas to determine risk factors for tumor recurrence and to assess the impact of surveillance imaging on patient outcome.<br />Methods: Data obtained in all children with intracranial ependymomas were prospectively entered into a database from January 1987 to June 2000. The imaging and clinical details in all patients were reviewed. Fifty-two children with histologically proven intracranial ependymomas were treated at the authors' institution; recurrences developed in 28 (54%) of them, with a median time from surgery to first recurrence of 14.5 months (range 3-65 months). Of these tumor recurrences, 43% were asymptomatic and were noted on surveillance imaging. Seventeen children died, all of whom had recurrences. Incomplete excision of the primary tumor was significantly associated with reduced time to recurrence (p = 0.0144) and time to death (p = 0.0472). The age of the patient, location of the primary tumor, histological findings, and the presence or absence of spinal metastases on preoperative imaging were not significantly associated with outcome. The risk of death at any given time was 12-fold greater in patients in whom a recurrence was identified due to symptoms rather than on surveillance images (p = 0.016).<br />Conclusions: Recurrent childhood ependymoma has a poor prognosis. The extent of the initial local tumor resection is the factor most closely associated with outcome. Surveillance imaging reveals a substantial number of asymptomatic recurrences, and survival appears to be improved in these patients compared with those identified by symptoms. The improvement in survival is thought to be greater than that expected just from earlier diagnosis.
- Subjects :
- Brain Neoplasms mortality
Brain Neoplasms surgery
Child
Child, Preschool
Ependymoma mortality
Ependymoma surgery
Female
Humans
Infant
Magnetic Resonance Imaging
Male
Neoplasm Recurrence, Local diagnosis
Prognosis
Tomography, X-Ray Computed
Brain Neoplasms diagnosis
Diagnostic Imaging
Ependymoma diagnosis
Population Surveillance methods
Subjects
Details
- Language :
- English
- ISSN :
- 0022-3085
- Volume :
- 94
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of neurosurgery
- Publication Type :
- Academic Journal
- Accession number :
- 11147894
- Full Text :
- https://doi.org/10.3171/jns.2001.94.1.0027