====== Ependymoma case series ======

Shi et al. analyzed adult and pediatric patients with newly diagnosed or recurrent [[intracranial ependymoma]] or [[spinal ependymoma]]s treated with [[SRS]] in [[Stanford]]. Following SRS, local failure (LF) was defined as failure within or adjacent to the SRS target volume, while distant failure (DF) was defined as failure outside of the SRS target volume. Time to LF and DF was analyzed using competing risk analysis with [[death]] as a competing risk. [[Overall survival]] (OS) was calculated from the date of first [[SRS]] to the date of death or censored at the date of last follow-up using the Kaplan-Meier method.

Twenty-one patients underwent SRS to 40 intracranial (n = 30) or spinal (n = 10) ependymoma lesions between 2007 and 2018, most commonly with 18 or 20 Gy in 1 fraction. Median follow-up for all patients after first SRS treatment was 54 months (range 2-157). The 1-year, 2-year, and 5-year rates of survival among patients with initial intracranial ependymoma were 86, 74, and 52%, respectively. The 2-year cumulative incidences of LF and DF after SRS among intracranial ependymoma patients were 25% (95% CI 11-43) and 42% (95% CI 22-60), respectively. No spinal ependymoma patient experienced LF, DF, or death within 2 years of SRS. Three patients had adverse radiation effects.

[[SRS]] is a viable treatment option for [[intracranial ependymoma]] and [[spinal ependymoma]] with excellent local control and acceptable toxicity
((Shi S, Jin MC, Koenig J, Gibbs IC, Soltys SG, Chang SD, Li G, Hayden Gephart
M, Hiniker SM, Pollom EL. Stereotactic Radiosurgery for Pediatric and Adult
Intracranial and Spinal Ependymomas. Stereotact Funct Neurosurg. 2019 Oct 7:1-6. 
doi: 10.1159/000502653. [Epub ahead of print] PubMed PMID: 31590165.
)).

==== 2015 ====

176 ependymoma samples (World Health Organization grade II and III) were reviewed at Huashan Hospital. Both children and adults were included. 

They performed multifactorial analyses of clinical prognostic factors and the biomolecular marker expressions of [[nucleolin]], [[epidermal growth factor receptor]] (EGFR) and caveolae-associated protein [[caveolin 1]] by immunohistochemistry. We identified the probabilities of progression-free survival and overall survival using univariate and multivariate statistical methods. The participants were diagnosed with ependymomas between 2002 and 2010, including distributions of tumor locations in intracranial and extracranial regions. Nucleolin was overexpressed in 67 % of our samples, demonstrating a subgroup with poor outcome; particularly infratentorial and anaplastic ependymomas. There was no significant correlation between the expression of EGFR and caveolin-1 and clinical outcomes. Clinically, inferior prognosis was observed with regard to age (<18 years), intracranial location, high grade ependymomas, and incomplete resection. We found that nucleolin was an unfavorable prognostic predictor for ependymomas. Moreover, our findings show a subset of aggravating outcomes in high-grade and posterior fossa tumors
((Chen C, Chen L, Yao Y, Qin Z, Chen H. Nucleolin overexpression is associated
with an unfavorable outcome for ependymoma: a multifactorial analysis of 176
patients. J Neurooncol. 2015 Nov 28. [Epub ahead of print] PubMed PMID: 26615563.)).

==== 1977 ====

One hundred and one patients with histologically confirmed ependymomas were studied over a 22-year period. Choroid plexus papilloma and subependymoma were not included. About half of the tumors were intracranial, with the majority of these infratentorial. The intraspinal tumors were equally divided between intramedullary and the "cauda" group. The majority of the intracranial tumors occurred in children, while almost all the intraspinal tumors were in adults. The histologic classification consisted of "typical ependymoma" (cellular, papillary and myxopapillary patterns) and "[[anaplastic ependymoma]]". The intracranial and intramedullary tumors showed a predominantly cellular pattern, while the myxopapillary type was found only in the "cauda" group. The histology seems to be of limited value in assessing the prognosis in an individual patient with ependymoma. The postoperative prognosis was poor in the intracranial tumors, although radiotherapy increased the survival time without affecting the eventual fatal outcome. The prognosis in the intraspinal group was much better, with three-fourths of the patients living for at least 10 years. No patient with an anaplastic tumor survived for more than 6 years
((Mork SJ, Loken AC. Ependymoma: a follow-up study of 101 cases. Cancer. 1977
Aug;40(2):907-15. PubMed PMID: 890671.
)).