Supratentorial ependymoma in children

Area of Science:

• Pediatric Neurosurgery
• Pediatric Oncology
• Neuro-oncology

Background:

• Supratentorial ependymomas (STE) in children lack detailed clinical and pathological characterization in existing literature.
• Most ependymoma studies group tumors by location and patient age, hindering specific understanding of STE.
• Pathological descriptions of STE remain debated due to limited specific data.

Purpose of the Study:

• To better characterize supratentorial ependymomas (STE) in pediatric patients.
• To compare STE with infratentorial ependymomas (ITE) to delineate differences.
• To suggest improved treatment guidelines for pediatric STE.

Main Methods:

• Retrospective review of 18 children operated for STE between 1985 and 1999.
• Comparison of clinical and pathological data of STE with infratentorial ependymomas (ITE).
• Analysis of factors affecting survival, including extent of resection and histological grade.

Main Results:

• Nearly half of pediatric STE cases occurred without connection to the ventricular system.
• Intraoperative bleeding and basal ganglia infiltration complicated resection in 4 cases, contributing to mortality and morbidity.
• Five-year overall survival and recurrence-free survival rates were 54% and 37%, respectively, significantly influenced by resection extent, not histological grade.

Conclusions:

• Extent of resection is a critical prognostic factor for pediatric supratentorial ependymomas (STE).
• High recurrence rates necessitate specific treatment strategies.
• Recommendations include limited postoperative irradiation for high-grade STE in older children and reoperation for subtotal removal or recurrence.