gms | German Medical Science

60th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Benelux countries and Bulgaria

German Society of Neurosurgery (DGNC)

24 - 27 May 2009, Münster

Oncological outcomes in patients with intracranial ependymomas

Meeting Abstract

  • J. Boström - Klinik für Neurochirurgie, Universitätsklinikum Bonn
  • A. Boström - Klinik für Neurochirurgie, Universitätsklinikum Bonn
  • M. Feuß - Klinik für Neurochirurgie, Universitätsklinikum Bonn
  • M. von Lehe - Klinik für Neurochirurgie, Universitätsklinikum Bonn
  • J. Schramm - Klinik für Neurochirurgie
  • W. Hartmann - Neuropathologie, Universitätsklinikum Bonn
  • M. Simon - Klinik für Neurochirurgie, Universitätsklinikum Bonn

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocP08-08

doi: 10.3205/09dgnc336, urn:nbn:de:0183-09dgnc3367

Published: May 20, 2009

© 2009 Boström et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: To evaluate the oncological outcome of patients with intracranial ependymomas.

Methods: Between 1988 and 2007, 27 consecutive patients were treated in our institution for an intracranial ependymoma. Pertinent clinical data and radiological and operative reports were retrieved from the patients’ charts. The histopathological findings of 25 cases were reviewed using the 2007 WHO classification. There were 14 males and 13 females with a mean age of 30 years (range 1–71) including 9 (33%) pediatric (<16 years) cases. Median follow-up was 84 months. Standard therapy consisted of a complete tumor resection whenever feasible. Adjuvant local radiation and/or chemotherapy were prescribed for patients diagnosed with WHO grade III or recurrent ependymomas.

Results: Infratentorial tumors were diagnosed in 22 patients, and supratentorial tumors in 5 cases. Histopathological findings were ependymoma WHO grade II in 15 patients, and anaplastic ependymoma WHO grade III in 13 patients. Complete tumor resection was achieved with the first operation in 20 cases (74%). Primary adjuvant therapy consisted of chemotherapy alone in a 17 months old child with an incompletely resected posterior fossa WHO grade III ependymoma, of radiation therapy alone in 4 cases, and of radiation therapy and chemotherapy in 7 cases. Tumor recurrence was seen in 8 cases (30%), including 5 patients with a grade II and 3 patients with a grade III ependymoma. Recurrent tumors were diagnosed between 10 months and 15 years after the first operation. Spinal dissemination was observed in only one case of a recurrent anaplastic ependymoma of the fourth ventricle. 5 year OS and PFS was 92% and 65% for WHO grade II ependymoma, respectively, and 78% and 78% for WHO grade III tumors. Supratentorial tumor location and a complete resection were associated with a relatively better prognosis. 5 year OS and PFS was 100% and 50% for supratentorial, and 83% and 75% for infratentorial tumors. 5 year OS and PFS was 94% and 72% following a complete resection, and 67% and 67% in patients with residual tumor.

Conclusions: Surgery alone as primary treatment will allow for good outcomes in most patients with WHO grade II ependymomas. Surprisingly similar results can be achieved with combined surgery and adjuvant local radiotherapy (and chemotherapy) in cases with ependymomas WHO grade III. (Spinal) dissemination should not be a major concern.