Prognosis by tumor location in adults with intracranial ependymomas.
Prognosis by tumor location in adults with intracranial ependymomas.
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DOI：
10.1016/j.jocn.2014.05.011
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发表时间：
2014-12
影响因子：
2
通讯作者：
Oh, Michael C.
中科院分区：
文献类型：
--
作者：
Sayegh, Eli T.;Aranda, Derick;Kim, Joseph M.;Oh, Taemin;Parsa, Andrew T.;Oh, Michael C.
颅内室管膜瘤在成人中是罕见的肿瘤。因此，影响预后的因素知之甚少。我们进行了一项研究，以探讨肿瘤位置是否是一个重要的预后因素，在成人谁接受手术治疗颅内室管膜瘤。检索PubMed，以确定报告颅内室管膜瘤成人患者临床结局的研究。提取患者和肿瘤特征、切除程度、无进展生存期（PFS）和总生存期（OS）的数据。肿瘤分为幕上或幕下、脑室外或脑室内。将临床特征和肿瘤特征制成表格。进行Kaplan-Meier和多变量考克斯回归生存分析，以确定不同肿瘤位置的PFS和OS。切除程度也通过肿瘤位置进行分析。共有183例患者被纳入荟萃分析。患者在平均8.2个月时出现各种临床特征。肿瘤平均大小为3.38 cm，19.3%的肿瘤为囊性。幕上肿瘤最常见于额叶和顶叶，幕下肿瘤最常见于第四脑室。幕上肿瘤的PFS（p < 0.001）和OS（p = 0.003）显著低于幕下肿瘤，尽管幕上肿瘤的大体全切除率（GTR）较高（72.6% vs 42.1%）。脑室外室管膜瘤的PFS显著低于脑室内室管膜瘤（p = 0.009）。总之，尽管幕上室管膜瘤更有利于GTR，但其PFS和OS明显低于幕下室管膜瘤，这表明临床侵袭性增加。与脑室内位置相比，脑室外位置也与PFS显著较差相关。
Intracranial ependymomas are rare tumors in adults. Thus, factors affecting prognosis are poorly understood. We performed a study to investigate whether tumor location is an important prognostic factor in adults who undergo surgery for intracranial ependymomas. PubMed was searched to identify studies that reported clinical outcomes in adult patients with intracranial ependymoma. Data were extracted for patient and tumor characteristics, extent of resection, progression-free survival (PFS), and overall survival (OS). Tumors were categorized as supratentorial or infratentorial and extraventricular or intraventricular. Presenting clinical features and tumor characteristics were tabulated. Kaplan–Meier and multivariate Cox regression survival analyses were performed to determine PFS and OS by tumor location. Extent of resection was also analyzed by tumor location. A total of 183 patients were included in the metaanalysis. Patients presented at a mean of 8.2 months with a myriad of clinical features. The mean tumor size was 3.38 cm, and 19.3% of tumors were cystic. Supratentorial tumors were most commonly located in the frontal and parietal lobes, and infratentorial tumors in the fourth ventricle. Supratentorial tumors demonstrated significantly poorer PFS (p < 0.001) and OS (p = 0.003) than infratentorial tumors, despite a higher rate of gross total resection (GTR) for the supratentorial tumors (72.6% versus 42.1%). Extraventricular ependymomas displayed significantly poorer PFS than intraventricular ependymomas (p = 0.009). In summary, supratentorial ependymomas have significantly poorer PFS and OS than their infratentorial counterparts, despite being more conducive to GTR, suggesting increased clinical aggressiveness. Extraventricular location is also associated with significantly poorer PFS than intraventricular location.
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