Ependymoma, NOS and anaplastic ependymoma incidence and survival in the United States varies widely by patient and clinical characteristics, 2000-2016
- 9 May 2020
- journal article
- research article
- Published by Oxford University Press (OUP) in Neuro-Oncology Practice
- Vol. 7 (5), 549-558
- https://doi.org/10.1093/nop/npaa023
Abstract
Ependymoma is a rare CNS tumor arising from the ependymal lining of the ventricular system. General differences in incidence and survival have been noted but not examined on a comprehensive scale for all ages and by histology. Despite the rarity of ependymomas, morbidity/mortality associated with an ependymoma diagnosis justifies closer examination. Incidence data were obtained from the Central Brain Tumor Registry of the United States in collaboration with the Centers for Disease Control and Prevention and the National Cancer Institute, and survival data from Surveillance Epidemiology and End Results, from 2000 to 2016 for anaplastic ependymoma and ependymoma, not otherwise specified (NOS). Age-adjusted incidence rates (IRs) per 100 000 person-years were analyzed by age, sex, race, and location. Survival analysis was performed with Kaplan-Meier curves and multivariable Cox proportional hazards models. Incidence of anaplastic ependymoma was highest in ages 0 to 4 years. African American populations had lower incidence but had a 78% increased risk of death compared to white populations (hazard ratio [HR]: 1.78 [95% CI, 1.30-2.44]). Incidence was highest for anaplastic ependymoma in the supratentorial region. Adults (age 40+ years) had almost twice the risk of death compared to children (ages 0-14 years) (HR: 1.97 [95% CI, 1.45-2.66]). For ependymoma, NOS, subtotal resection had a risk of mortality 1.86 times greater than gross total resection ([HR: 1.86 [95% CI, 1.32-2.63]). African American populations experienced higher mortality rates despite lower incidence compared to white populations. Extent of resection is an important prognostic factor for survival. This highlights need for further evaluation of treatment patterns and racial disparities in the care of patients with ependymoma subtypes.Keywords
Funding Information
- Centers for Disease Control and Prevention (75D30119C06056)
- American Brain Tumor Association
- Sontag Foundation
- Novocure
- Musella Foundation For Brain Tumor Research and Information
- National Brain Tumor Society
- Zelda Dorin Tetenbaum Memorial Fund
This publication has 30 references indexed in Scilit:
- Histologic grade and extent of resection are associated with survival in pediatric spinal cord ependymomasChild's Nervous System, 2013
- Management of Pediatric Myxopapillary Ependymoma: The Role of Adjuvant RadiationInternational Journal of Radiation Oncology*Biology*Physics, 2012
- Predictors of survival among older adults with ependymomaJournal of Neuro-Oncology, 2011
- Delineation of Two Clinically and Molecularly Distinct Subgroups of Posterior Fossa EpendymomaCancer Cell, 2011
- Age–incidence patterns of primary CNS tumors in children, adolescents, and adults in EnglandNeuro-Oncology, 2009
- Incidence patterns for ependymoma: a Surveillance, Epidemiology, and End Results studyJournal of Neurosurgery, 2009
- Both location and age predict survival in ependymoma: A SEER studyPediatric Blood & Cancer, 2008
- Comparison of effects of socioeconomic and geographic variations on survival for adults and children with gliomaJournal of Neurosurgery: Pediatrics, 2006
- Spinal myxopapillary ependymoma outcomes in patients treated with surgery and radiotherapy at M.D. Anderson Cancer CenterJournal of Neuro-Oncology, 2006
- Radial glia cells are candidate stem cells of ependymomaCancer Cell, 2005