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Surveillance imaging in pediatric ependymoma
Darren Klawinski1,2, Daniel J Indelicato3, Jobayer Hossain4
1Division of Pediatric Hematology/Oncology, Nemours Children's Specialty Care and Wolfson Children's Hospital, Jacksonville, Florida.
Pediatric Blood & Cancer
|August 4, 2020
Summary
Early detection of pediatric ependymoma relapse via surveillance imaging may improve survival outcomes. However, the overall survival benefit of frequent imaging for asymptomatic patients remains unclear due to limited salvage therapies.
Area of Science:
- Pediatric Oncology
- Neuro-oncology
- Medical Imaging
Background:
- Ependymoma management in children involves surveillance imaging to detect recurrences.
- The survival benefit of early detection through imaging is not well-established.
Purpose of the Study:
- To determine if detecting ependymoma relapses via surveillance imaging improves survival in pediatric patients.
Main Methods:
- Retrospective chart review of pediatric ependymoma patients (<21 years) diagnosed between 2003-2016.
- Analysis of relapse details, including detection method (surveillance imaging vs. symptoms) and subsequent therapy.
- Median follow-up of 6.5 years from diagnosis and 3.5 years from relapse.
Main Results:
- 45% of patients relapsed; 68% were detected by surveillance imaging, 32% by symptoms.
- 3-year survival after relapse was 62% for surveillance-detected vs. 55% for symptom-detected (P=0.063).
- 3-year second progression-free survival (SPFS) was significantly better in the surveillance group (45% vs. 32%, P=0.028).
Conclusions:
- Surveillance imaging may detect recurrences when they are more treatable, leading to better SPFS.
- The survival advantage of frequent surveillance imaging in asymptomatic pediatric ependymoma patients remains ambiguous due to limited salvage options.
