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64th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

26 - 29 May 2013, Düsseldorf

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A German multi-center analysis of treatment effects and quality of life in adult patients with cranial ependymomas

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  • Stephan Dützmann - Department of Neurosurgery, Goethe University Frankfurt, Frankfurt
  • Bawarjan Schatlo - Department of Neurosurgery, University Hospital Geneva,Genève, Switzerland
  • Michael Murek - Department of Neurosurgery, Inselspital Bern, Bern, Switzerland
  • Maria Wostrack - Department of Neurosurgery, Technical University Munich, München
  • Carolin Weiss - Department of Neurosurgery, University Hospital Cologne, Köln
  • Karl Schaller - Department of Neurosurgery, University Hospital Geneva,Genève, Switzerland
  • Andreas Raabe - Department of Neurosurgery, Inselspital Bern, Bern, Switzerland
  • Bernhard Meyer - Department of Neurosurgery, Technical University Munich, München
  • Roland Goldbrunner - Department of Neurosurgery, University Hospital Cologne, Köln
  • Kea Franz - Department of Neurosurgery, Goethe University Frankfurt, Frankfurt
  • Volker Seifert - Department of Neurosurgery, Goethe University Frankfurt, Frankfurt
  • Christian Senft - Department of Neurosurgery, Goethe University Frankfurt, Frankfurt

Deutsche Gesellschaft für Neurochirurgie. 64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Düsseldorf, 26.-29.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. DocMO.05.05

doi: 10.3205/13dgnc042, urn:nbn:de:0183-13dgnc0423

Published: May 21, 2013

© 2013 Dützmann et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: We sought to retrospectively analyze outcome and quality of life of adult patients that were operated on intracranial ependymomas at 4 different surgical centers in 2 countries

Method: We retrospectively searched our patient-databases at our 4 institutions. All patients were attempted to contact via telephone to assess Quality of life at the time of the telephone interview. The standard EORTC Quality of Life Questionnaire C30 (EORTC QLQ-C30) and the EORTC QLQ-Brain Cancer Module (QLQ-BN20) were used.

Results: 64 patients with adult intracranial ependymomas were included in the study. 18 (28.1%) patients had WHO Grade I, 33 (51.6%) patients WHO Grade II and 13 (20.3%) patients WHO Grade III tumors. 42 (65.6 %) tumors were located infratentorially and 22 (34.4 %) tumors supratentorially. Mean follow-up was 67 months (range 0-545). In 46 (76.6%) patients a complete resection could be achieved (WHO Grade I: 17; WHO Grade II: 19; WHO Grade III: 10). During the follow-up period 10 (15%) patients died.Median Overall Survival (OS) was 47 months. The only factor that was statistically significantly associated with increased survival was age <55 years (p< 0.001). Supratentorial location was statistically significantly correlated with shorter PFS (p=0.048). In WHO Grade II tumors local irradiation did not lead to increased PFS (p=0.888) or OS (p=0.801). Even in the incompletely resected Grade II tumors local irradiation did not lead to a statistically significant benefit in PFS (p=0.911). Lastly we found that radiation therapy had a significant, negative impact on patients QoL. In a multivariate analysis irradiated patients had significantly more “Fatigue” than non-irradiated patients.

Conclusions: Supratentorial location should alert treatment providers to close follow-up of ependymoma patients. Radiation therapy in WHO Grade II needs to be reassessed in tumor boards in view of the questionable effect on survival and negative influence on patients’ fatigue levels.