Clinical characteristics, treatment, and survival outcome of ependymoma in infants

Objectives: The treatment modalities of ependymoma in infants remains controversial. Postoperative adjuvant radiotherapy (RT) could prolong the overall survival but has the potential to affecting nervous system development in infants. The role of adjuvant chemotherapy (CT) in prolonging overall survival for infants with ependymoma is still unclear. Therefore, we designed this study to explore the effect of treatment modalities on survival time of infants with ependymoma. Methods: A total of 72 infants with ependymoma from the Surveillance, Epidemiology, and End Results (SEER) database in this retrospective analysis. Univariate and multivariate Cox proportional hazard models were adopted to determine hazard ratios and to compare overall survival. Results: Among 72 infants with ependymoma, 35 were male (48.6%) and 37 were female (51.4%). The 5-year overall survival of all patients was 67.0%. 46 infants (63.9%) received gross total resection (GTR), 20 (27.8%) received subtotal resection (STR), and 6 (8.3%) did not receive surgical resection or only autopsy. 21 infants (29.2%) received RT, and 45 (62.5%) received CT. Multivariate analysis revealed that patients accepted surgical resection (No vs GTR, P < 0.001; No vs STR, P = 0.026) and chemotherapy (No vs Yes, P = 0.024) are the independent prognostic factors for overall survival. Conclusion: Treatment modality is associated with survival time in infants with ependymoma. The extent of resection and CT were independent prognostic factors for infants with ependymoma.