Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Prognostic Factors affecting Recurrence in 30 Patients with Intracranial Ependymomas

두개강내 상의세포종 환자 30례에 있어서 재발에 영향을 주는 예후 인자

  • Rhee, Hae Il (Department of Neurological Surgery, Asan Medical Center, College of Medicine, University of Ulsan) ;
  • Ahn, Jae Sung (Department of Neurological Surgery, Asan Medical Center, College of Medicine, University of Ulsan) ;
  • Jeon, Sang Ryong (Department of Neurological Surgery, Asan Medical Center, College of Medicine, University of Ulsan) ;
  • Kim, Jeong Hoon (Department of Neurological Surgery, Asan Medical Center, College of Medicine, University of Ulsan) ;
  • Rha, Young Shin (Department of Neurological Surgery, Asan Medical Center, College of Medicine, University of Ulsan) ;
  • Kim, Chang Jin (Department of Neurological Surgery, Asan Medical Center, College of Medicine, University of Ulsan) ;
  • Kwun, Byung Duk (Department of Neurological Surgery, Asan Medical Center, College of Medicine, University of Ulsan)
  • 이해일 (울산대학교 의과대학 서울중앙병원 신경외과학교실) ;
  • 안재성 (울산대학교 의과대학 서울중앙병원 신경외과학교실) ;
  • 전상룡 (울산대학교 의과대학 서울중앙병원 신경외과학교실) ;
  • 김정훈 (울산대학교 의과대학 서울중앙병원 신경외과학교실) ;
  • 나영신 (울산대학교 의과대학 서울중앙병원 신경외과학교실) ;
  • 김창진 (울산대학교 의과대학 서울중앙병원 신경외과학교실) ;
  • 권병덕 (울산대학교 의과대학 서울중앙병원 신경외과학교실)
  • Received : 2001.08.29
  • Accepted : 2001.11.09
  • Published : 2001.12.31
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Abstract

Objective : The goal of this study was to identify variables that were predictive of recurrence in primary intracranial ependymomas. Methods : We analyzed variables affecting recurrence in 30 patients with primary intracranial ependymomas. Age, location, CSF cytology, seeding on neuroimaging study, tumor grade, extent of surgery, use of chemotherapy, chemotherapy regimen, use of radiotherapy, and radiotherapy field were entered to test their impacts on recurrence. Results : Follow-up ranged from 2 to 110 months. Tumors were recurred at the primary tumor site only in 13 patients (43.3%). The overall average recurrence free period was 55 months, with overall recurrence free rates at 3 and 6 years of 61.0% and 20.9%, respectively. Extent of surgery was the strongest variable affecting recurrence. The median recurrence free period and 3-year recurrence free rate were 72 months and 78.4% for patients having complete excision and 33 months and 0% for those having incomplete excision(p=0.05). Other prognostic variables like age, location, tumor grade, use of chemotherapy, and use of radiotherapy did not affect recurrence(p=0.2848, 0.7899, 0.1714, 0.2157, 0.7076, respectively). Conclusions : Intracranial ependymomas have a propensity to recur after treatment, and recurrence at the primary site is still the main obstacle to cure. Among various variables, only extent of resection had the strongest impact on recurrence. Additional studies may still be needed to precisely define the prognostic variables on recurrence in intracranial ependymomas.

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