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Pediatric ependymoma: A single-center experience from a developing country.
Mahmoud Hammad1, Maryhan Hosny1, Ehab M Khalil2
1Department of Pediatric Oncology and Hematology, National Cancer Institute (NCI), Cairo University; Department of Pediatric Oncology and Hematology, Children's Cancer Hospital of Egypt (CCHE/57357), Cairo, Egypt.
Maximal surgical resection and adequate radiotherapy significantly improve outcomes for pediatric ependymoma. However, challenges in resource-limited countries hinder optimal treatment, impacting survival rates for these central nervous system tumors.
Area of Science:
- Pediatric neuro-oncology
- Central nervous system (CNS) tumors
- Pediatric oncology
Background:
- Ependymomas are the third most common pediatric CNS tumors, representing 6-12% of childhood brain tumors.
- Recurrence rates exceed 50%, particularly when complete resection is not achieved prior to radiotherapy.
- Overall survival (OS) and progression-free survival (PFS) rates are suboptimal, ranging from 39-64% and 23-45% at 5 years, respectively.
Purpose of the Study:
- To report OS and PFS rates for pediatric ependymoma cases.
- To evaluate the impact of various factors on disease outcomes.
- To highlight challenges affecting treatment in resource-limited settings.
Main Methods:
- Retrospective cohort study.
- Single-center experience at the National Cancer Institute, Cairo University.
- Included 47 pediatric patients treated between January 2009 and December 2014.
Main Results:
- Median follow-up was 23.5 months.
- Average 3-year OS and PFS rates were 43.7% and 43.3%, respectively.
- Maximal surgical resection and adequate postoperative radiotherapy were significant prognostic factors.
Conclusions:
- Surgical extent and radiotherapy adequacy are key determinants of pediatric ependymoma outcomes.
- Treatment outcomes in developing countries lag due to insufficient surgical excision and radiotherapy.
- Addressing resource limitations is crucial for improving survival rates.
