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Two Decades of Childhood Ependymoma Experience at a Tertiary Cancer Center in Turkey
Selma Cakmakci1, Harun Demirci2, Gonca Altinisik Inan3
1Department of Pediatric Hematology and Oncology, Ankara Bilkent City Hospital, Ankara 06800, Türkiye.
Insights
Gross total resection (GTR) significantly improves survival outcomes for pediatric ependymoma patients. Chemotherapy and radiotherapy may prolong survival in cases of relapsed ependymoma.
Area of Science:
- Pediatric Oncology
- Neuro-oncology
- Central Nervous System Tumors
Background:
- Ependymoma is the third most common malignant central nervous system tumor in children.
- Effective treatment strategies are crucial for improving outcomes in pediatric ependymoma.
Purpose of the Study:
- To review treatment experience for pediatric ependymoma at Ankara Bilkent City Hospital.
- To evaluate the impact of different treatment modalities on patient survival.
Main Methods:
- Retrospective review of medical records for children diagnosed with ependymoma between 2006 and 2024.
- Analysis of clinical, pathological, radiological, treatment, and outcome data.
- Univariate analysis to assess the impact of resection extent on event-free survival (EFS) and overall survival (OS).
Main Results:
- Thirty-two pediatric patients were included, with a median age of 6.8 years.
- Gross total resection (GTR) was associated with significantly better 3-year EFS (79.0%) and OS (100%) compared to subtotal resection (STR).
- Radiotherapy and chemotherapy were administered to varying patient subgroups, with combined therapy in 11 patients.
Conclusions:
- Gross total resection (GTR) is associated with the best outcomes in pediatric ependymoma.
- Event-free survival (EFS) and overall survival (OS) rates are comparable to existing literature.
- Chemotherapy and radiotherapy may offer survival benefits for patients with relapsed ependymoma.
Purpose:
We aim to review our experience in treating children with ependymoma, the third most common malignant central nervous system tumor in children, at Ankara Bilkent City Hospital.
Methods:
We reviewed medical records of children <18 years old at diagnosis with ependymoma followed up between 2006 and 2024. Clinical, pathological, radiological, treatment, and outcome data were evaluated.
Results:
Thirty-two patients (56% males) were included. Median age at diagnosis was 6.8 years (range: 0.6-17 years). Sixteen tumors (50%) were Grade 2 histology. Resection extent was gross total resection (GTR, n = 16), subtotal resection (STR, n = 15), or biopsy (n = 1). Radiotherapy was given to 10 patients; chemotherapy to 3; and both to 11. Eight patients underwent surgery only. In univariate analysis, resection extent significantly impacted both event-free survival (EFS) (3-year EFS 79.0% in GTR vs. 38.9% in STR, p = 0.009) and overall survival (3-year OS 100% in GTR vs. 79.4% in STR, p = 0.035). Four patients (12.5%) died. Six patients remained alive with active disease; three were lost to follow-up.
Conclusions:
The best outcomes occurred in patients who underwent GTR. The EFS/OS rates were comparable to those in the literature. Our findings suggest that chemotherapy and radiotherapy in relapsed ependymoma may prolong survival.
