A systematic review and meta-analysis of outcomes in pediatric, recurrent ependymoma
The purpose of this study was to determine outcomes in recurrent pediatric ependymoma.
We performed a systematic review of PubMed, Embase, Web of Science and the Cochrane Library for studies reporting on survival outcomes for pediatric patients with recurrent ependymoma. We then performed a meta-analysis of all eligible results. Survival outcomes were identified across location of recurrence, therapy at recurrence, and age at recurrence.
Eleven studies met final inclusion criteria. Pooled median progression free survival (PFS) from date of first recurrence was 6.7 months (95% confidence interval [95% CI] 4.7–8.8). Pooled median overall survival (OS) from date of first recurrence was 11.2 months (95% CI 6.4–16.0). Participants with supratentorial recurrences demonstrated a shorter OS of 8.3 months (95% CI 3.2–13.3) compared to 20.1 months (95% CI 8.4–31.7) for those with infratentorial recurrence. Patients who underwent surgery at recurrence had a median OS of 24.2 months (95% CI 14.2–34.1) compared to 29.2 months (95% CI 17.4–41.1) in those who received radiation compared to 19.3 months (95% CI 10.3–28.3) in those who received chemotherapy. Patients younger than age 3 years at time of recurrence demonstrated a median OS of 31.0 months (95% CI − 25.3–87.3) compared to 17.5 months (95% CI 9.9–25.2) for those that recurred beyond 3 years of age.
Our findings illustrate that children with recurrent ependymoma suffer from poor outcomes; however, these outcomes range widely depending on patient, tumor, and treatment characteristics. New therapies and treatment strategies are needed to improve outcomes in this group.
KeywordsPediatric Recurrent Ependymoma Systematic review
LB is in part supported by grants from the National Center for Advancing Translational Sciences of the National Institutes of health (TL1TR001871). CK is supported by grants from the Frank A. Campini Foundation, Cannonball Kids’ Cancer (A129749), and National Institutes of Health National Center for Advancing Translational Sciences (KL2TR001870). This content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
No external funding was used to directly support this study.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest.
All information gathering and analyses were in accordance with the ethical standards of the UCSF IRB. Accordingly, this study did not require IRB approval given its usage of only unidentifiable information from the literature.
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