Retrospective analysis of treatment outcome of pediatric ependymomas in Korea: Analysis of Korean multi-institutional data

Yeon Joo Kim, Joo Young Kim, Do Hoon Lim, Hyeon Jin Park, Jungnam Joo, Ki Woong Sung, Hyung Jin Shin, Seung Ki Kim, Ji Hoon Phi, Il Han Kim, Kyung Duk Park, Seung Do Ahn, Jinhong Jung, Young Sin Rha, Dong Seok Kim, Chang Ok Suh

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

We analyzed the treatment outcomes of intracranial ependymomas in Korean children aged <18 years. Data for 96 patients were collected from five hospitals. Survival rates were calculated using the Kaplan-Meier method. Log-rank tests for univariate analyses and Cox regression model for multivariate analysis were conducted to identify prognostic factors for survival. The median age of the patients was 4 years (range, 0.3-17.9 years). The median follow-up was 55 months (range, 2-343 months). Age <3 years was an important factor for selecting adjuvant therapy after surgery. Among children aged <3 and ≥3 years, adjuvant radiotherapy (RT) was applied to 55 and 84 %, respectively, and adjuvant chemotherapy to 52 and 10 %, respectively. The 5 year local progression-free survival (LPFS), disease-free survival (DFS), and overall survival (OS) rates were 54, 52, and 79 %, respectively. Gross total resection was the most significant prognostic factor for all survival endpoints. Age ≥3 years and RT were significant prognostic factors for superior LPFS and DFS. However, the significance of age was lost in multivariate analysis for DFS. LPFS, DFS, and OS were superior in patients who started RT within 44 days after surgery (the median time) than in patients who started RT later in the patients aged ≥3 years. Postoperative RT was a strong prognostic factor for intracranial ependymomas. Our results suggest that early use of RT is an essential component of treatment, and should be considered in young children.

Original languageEnglish
Pages (from-to)39-48
Number of pages10
JournalJournal of Neuro-Oncology
Volume113
Issue number1
DOIs
Publication statusPublished - 2013 Jan 1

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Ependymoma
Korea
Disease-Free Survival
Pediatrics
Radiotherapy
Survival
Multivariate Analysis
Survival Rate
Adjuvant Radiotherapy
Adjuvant Chemotherapy
Ambulatory Surgical Procedures
Proportional Hazards Models
Regression Analysis
Therapeutics

All Science Journal Classification (ASJC) codes

  • Oncology
  • Neurology
  • Clinical Neurology
  • Cancer Research

Cite this

Kim, Yeon Joo ; Kim, Joo Young ; Lim, Do Hoon ; Park, Hyeon Jin ; Joo, Jungnam ; Sung, Ki Woong ; Shin, Hyung Jin ; Kim, Seung Ki ; Phi, Ji Hoon ; Kim, Il Han ; Park, Kyung Duk ; Ahn, Seung Do ; Jung, Jinhong ; Rha, Young Sin ; Kim, Dong Seok ; Suh, Chang Ok. / Retrospective analysis of treatment outcome of pediatric ependymomas in Korea : Analysis of Korean multi-institutional data. In: Journal of Neuro-Oncology. 2013 ; Vol. 113, No. 1. pp. 39-48.
@article{d2c5856bfdbd4313bb6203670c22547d,
title = "Retrospective analysis of treatment outcome of pediatric ependymomas in Korea: Analysis of Korean multi-institutional data",
abstract = "We analyzed the treatment outcomes of intracranial ependymomas in Korean children aged <18 years. Data for 96 patients were collected from five hospitals. Survival rates were calculated using the Kaplan-Meier method. Log-rank tests for univariate analyses and Cox regression model for multivariate analysis were conducted to identify prognostic factors for survival. The median age of the patients was 4 years (range, 0.3-17.9 years). The median follow-up was 55 months (range, 2-343 months). Age <3 years was an important factor for selecting adjuvant therapy after surgery. Among children aged <3 and ≥3 years, adjuvant radiotherapy (RT) was applied to 55 and 84 {\%}, respectively, and adjuvant chemotherapy to 52 and 10 {\%}, respectively. The 5 year local progression-free survival (LPFS), disease-free survival (DFS), and overall survival (OS) rates were 54, 52, and 79 {\%}, respectively. Gross total resection was the most significant prognostic factor for all survival endpoints. Age ≥3 years and RT were significant prognostic factors for superior LPFS and DFS. However, the significance of age was lost in multivariate analysis for DFS. LPFS, DFS, and OS were superior in patients who started RT within 44 days after surgery (the median time) than in patients who started RT later in the patients aged ≥3 years. Postoperative RT was a strong prognostic factor for intracranial ependymomas. Our results suggest that early use of RT is an essential component of treatment, and should be considered in young children.",
author = "Kim, {Yeon Joo} and Kim, {Joo Young} and Lim, {Do Hoon} and Park, {Hyeon Jin} and Jungnam Joo and Sung, {Ki Woong} and Shin, {Hyung Jin} and Kim, {Seung Ki} and Phi, {Ji Hoon} and Kim, {Il Han} and Park, {Kyung Duk} and Ahn, {Seung Do} and Jinhong Jung and Rha, {Young Sin} and Kim, {Dong Seok} and Suh, {Chang Ok}",
year = "2013",
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Kim, YJ, Kim, JY, Lim, DH, Park, HJ, Joo, J, Sung, KW, Shin, HJ, Kim, SK, Phi, JH, Kim, IH, Park, KD, Ahn, SD, Jung, J, Rha, YS, Kim, DS & Suh, CO 2013, 'Retrospective analysis of treatment outcome of pediatric ependymomas in Korea: Analysis of Korean multi-institutional data', Journal of Neuro-Oncology, vol. 113, no. 1, pp. 39-48. https://doi.org/10.1007/s11060-013-1087-5

Retrospective analysis of treatment outcome of pediatric ependymomas in Korea : Analysis of Korean multi-institutional data. / Kim, Yeon Joo; Kim, Joo Young; Lim, Do Hoon; Park, Hyeon Jin; Joo, Jungnam; Sung, Ki Woong; Shin, Hyung Jin; Kim, Seung Ki; Phi, Ji Hoon; Kim, Il Han; Park, Kyung Duk; Ahn, Seung Do; Jung, Jinhong; Rha, Young Sin; Kim, Dong Seok; Suh, Chang Ok.

In: Journal of Neuro-Oncology, Vol. 113, No. 1, 01.01.2013, p. 39-48.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Retrospective analysis of treatment outcome of pediatric ependymomas in Korea

T2 - Analysis of Korean multi-institutional data

AU - Kim, Yeon Joo

AU - Kim, Joo Young

AU - Lim, Do Hoon

AU - Park, Hyeon Jin

AU - Joo, Jungnam

AU - Sung, Ki Woong

AU - Shin, Hyung Jin

AU - Kim, Seung Ki

AU - Phi, Ji Hoon

AU - Kim, Il Han

AU - Park, Kyung Duk

AU - Ahn, Seung Do

AU - Jung, Jinhong

AU - Rha, Young Sin

AU - Kim, Dong Seok

AU - Suh, Chang Ok

PY - 2013/1/1

Y1 - 2013/1/1

N2 - We analyzed the treatment outcomes of intracranial ependymomas in Korean children aged <18 years. Data for 96 patients were collected from five hospitals. Survival rates were calculated using the Kaplan-Meier method. Log-rank tests for univariate analyses and Cox regression model for multivariate analysis were conducted to identify prognostic factors for survival. The median age of the patients was 4 years (range, 0.3-17.9 years). The median follow-up was 55 months (range, 2-343 months). Age <3 years was an important factor for selecting adjuvant therapy after surgery. Among children aged <3 and ≥3 years, adjuvant radiotherapy (RT) was applied to 55 and 84 %, respectively, and adjuvant chemotherapy to 52 and 10 %, respectively. The 5 year local progression-free survival (LPFS), disease-free survival (DFS), and overall survival (OS) rates were 54, 52, and 79 %, respectively. Gross total resection was the most significant prognostic factor for all survival endpoints. Age ≥3 years and RT were significant prognostic factors for superior LPFS and DFS. However, the significance of age was lost in multivariate analysis for DFS. LPFS, DFS, and OS were superior in patients who started RT within 44 days after surgery (the median time) than in patients who started RT later in the patients aged ≥3 years. Postoperative RT was a strong prognostic factor for intracranial ependymomas. Our results suggest that early use of RT is an essential component of treatment, and should be considered in young children.

AB - We analyzed the treatment outcomes of intracranial ependymomas in Korean children aged <18 years. Data for 96 patients were collected from five hospitals. Survival rates were calculated using the Kaplan-Meier method. Log-rank tests for univariate analyses and Cox regression model for multivariate analysis were conducted to identify prognostic factors for survival. The median age of the patients was 4 years (range, 0.3-17.9 years). The median follow-up was 55 months (range, 2-343 months). Age <3 years was an important factor for selecting adjuvant therapy after surgery. Among children aged <3 and ≥3 years, adjuvant radiotherapy (RT) was applied to 55 and 84 %, respectively, and adjuvant chemotherapy to 52 and 10 %, respectively. The 5 year local progression-free survival (LPFS), disease-free survival (DFS), and overall survival (OS) rates were 54, 52, and 79 %, respectively. Gross total resection was the most significant prognostic factor for all survival endpoints. Age ≥3 years and RT were significant prognostic factors for superior LPFS and DFS. However, the significance of age was lost in multivariate analysis for DFS. LPFS, DFS, and OS were superior in patients who started RT within 44 days after surgery (the median time) than in patients who started RT later in the patients aged ≥3 years. Postoperative RT was a strong prognostic factor for intracranial ependymomas. Our results suggest that early use of RT is an essential component of treatment, and should be considered in young children.

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