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Supratentorial Parenchymal Ependymomas in Children: Experience with 14 Patients at a Single Institute
Luxin Yin1, Chunde Li, Shiqi Luo
1The Affiliated Hospital of Xu Zhou Medical College, Department of Neurosurgery, Xuzhou, Jiangsu Province, China.
Insights
Gross total surgical removal (GTR) offers a favorable long-term outcome for pediatric supratentorial parenchymal ependymomas. Subtotal removal (STR) is associated with higher recurrence rates and poorer prognosis in these challenging pediatric brain tumors.
Area of Science:
- Pediatric neurosurgery
- Pediatric oncology
- Neuro-oncology
Background:
- Supratentorial parenchymal ependymomas are rare pediatric brain tumors.
- Accurate preoperative diagnosis can be challenging.
- Treatment strategies significantly impact patient outcomes.
Purpose of the Study:
- To investigate clinical features, imaging, treatment, and prognosis of pediatric supratentorial parenchymal ependymomas.
- To evaluate the efficacy of gross total surgical removal (GTR) versus subtotal removal (STR).
- To identify factors influencing long-term outcomes.
Main Methods:
- Retrospective review of 14 pediatric patients treated between 2004 and 2010.
- Analysis of clinical data, neuroimaging, surgical techniques, and follow-up outcomes.
- Categorization of tumors into ependymomas, anaplastic ependymomas, and subependymomas.
Main Results:
- Gross total surgical removal (GTR) was achieved in 10 patients, with 71.4% experiencing excellent outcomes.
- Subtotal removal (STR) in four patients led to recurrent tumors and mortality.
- Anaplastic ependymomas were the most common subtype (7 cases).
Conclusions:
- Preoperative diagnosis of these tumors is difficult.
- Improved microsurgical techniques enable GTR, leading to favorable long-term outcomes.
- GTR is crucial for improving prognosis in pediatric supratentorial parenchymal ependymomas.
Aim:
To study the clinical features, imaging findings, treatment methods and results, and prognosis of supratentorial parenchymal ependymomas in children.
Material And Methods:
Fourteen children with supratentorial parenchymal ependymomas were treated by the senior author at Tiantan Hospital between October 2004 and May 2010. The clinical manifestations, neuroimaging findings, treatment methods, and therapeutic results were retrospectively reviewed.
Results:
The study included 11 boys and three girls. The patients were aged from 1 to 14 years with an average age of 6.1 years. Gross total surgical removal (GTR) was achieved in 10 cases, and subtotal removal (STR) was achieved in four cases. There were six ependymomas, seven anaplastic ependymomas, and one subependymoma. The mean follow-up duration was 78.9 months (range, 4?122 months). During the follow-up period, 10 patients who underwent GTR (71.4%; only 1 patient had a recurrent tumor during this time) had an excellent postoperative outcome (Karnofsky Performance Status ? 80), while four patients who underwent STR (28.6%) developed recurrent tumors and died.
Conclusion:
The preoperative diagnosis of supratentorial parenchymal ependymomas is difficult. GTR can be achieved with a favorable long-term outcome using an improved microsurgical technique.
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