Ependymoma: Prognostic Factors and Survival Outcomes in CNS Tumors

The ependymoma is a rare type of tumor of the central nervous system (CNS) that originates in ependymal cells. These tumors can occur in various locations within the CNS, including the brain and spinal cord, and are classified by grade according to their aggressiveness. Understanding the prognostic factors and the evolution of survival in patients with ependymoma is crucial for developing personalized treatment strategies.

Prognostic Factors and Survival Outcomes

The prognostic factors in ependymoma include clinical and molecular characteristics that can influence patients' life expectancy. A recent study has identified that the molecular subclassification of ependymoma, along with the extent of surgical resection and the Ki-67 proliferation index, are significant independent prognostic indicators for survival in adults with intracranial ependymoma [1].

The molecular classification has allowed for improved diagnostic accuracy and has revealed molecular subgroups that have prognostic and therapeutic implications [2]. For instance, ependymomas with RELA fusion in supratentorial locations and those with loss of H3K27 methylation in the posterior fossa have a more unfavorable prognosis [1].

Regarding survival, studies have shown that total tumor resection and postoperative radiotherapy are key factors in improving progression-free survival in certain molecular subgroups of ependymoma [3]. However, radiotherapy must be carefully considered in pediatric patients due to its potential effects on the development of the nervous system [4].

Conclusions

The management of ependymoma requires a multidisciplinary approach that considers both clinical and molecular prognostic factors. The identification of specific molecular subgroups has enhanced our ability to predict survival and tailor treatments. Complete surgical resection remains a primary goal, and radiotherapy may be beneficial in certain cases, although its use must be carefully evaluated, especially in young patients. Ongoing research into the molecular biology of ependymoma promises to further improve treatment strategies and outcomes for patients.

Referencias

• [1] Survival and Prognostic Factors of Adult Intracranial Ependymoma: A Single-institutional Analysis of 236 Patients.
• [2] Molecular pathology of tumors of the central nervous system.
• [3] Adult intracranial ependymoma-relevance of DNA methylation profiling for diagnosis, prognosis, and treatment.
• [4] Pediatric Brain Tumors.

Created 14/1/2025