Nucleolin was overexpressed in 67 % of ependymoma samples, demonstrating a subgroup with poor outcome; particularly infratentorial ependymoma 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. Chen et al. found that nucleolin was an unfavorable prognostic predictor for ependymomas. Moreover, the findings show a subset of aggravating outcomes in high-grade and infratentorial ependymoma. ¹⁾.

NCL and HTERT represent the strongest prognostic biomarkers of RFS and OS, respectively, in a ependymoma case series ²⁾.

Biomolecular studies have identified that gain of 1q25 and EGFR overexpression correlate to poor prognosis, whereas low expression of nucleolin correlated with a favorable outcome ³⁾.

Low nucleolin expression was the single most important biological predictor of outcome in pediatric intracranial ependymoma. Furthermore, telomerase reactivation and maintenance of telomeric repeats appear necessary for childhood ependymoma progression. These findings require corroboration in a clinical trial setting ⁴⁾.