Materiały źródłowe

• #1 Ependymoma – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538244/

  Ependymomas affect all age groups, with a higher frequency in children. It is the third most common brain tumor in pediatric patients. As per the Central Brain Tumor Registry of the United States (CBTRUS) Statistical Report for CNS tumors from the years 2011 to 2015, ependymal tumors represent 1.7% of all brain and CNS tumors, with a median age of 44 years. In childhood, brain tumors are the primary cause of death associated with solid tumors. The most common pediatric brain tumors being medulloblastoma, pilocytic astrocytoma, brainstem glioma, and ependymoma. […] Ependymal tumors are rare, constituting 1.7% of all brain tumors, as reported in the most recent CBTRUS statistical report; this poses a challenge in defining the optimal management for these entities.

• #2

  https://link.springer.com/article/10.1007/s11912-022-01260-w

  Ependymomas may occur either in the brain or in the spinal cord. Compared with intracranial ependymomas, spinal ependymomas are less frequent and exhibit a better prognosis. According to the Central Brain Tumor Registry of the USA, the annual incidence of ependymomas ranges from 0.29 to 0.6 per 100,000 persons. These tumors account for 1.6-1.8% of all primary CNS tumors: in children they are proportionally more common being 5.2%, while in adults are around 4%. Males are slightly more affected than females (1.3:1). Tumor location is largely dependent on patient age, with approximately 90% of pediatric ependymomas occurring intracranially, and 65% of adult tumors occurring in the spinal cord. […] Given the low incidence, the literature regarding intracranial ependymomas in adults is sparse, as most series combine pediatric and adult ependymomas, grade II and grade III tumors, are retrospective, include limited numbers of patients, and span several decades in which diagnostic and therapeutic modalities have changed. Conversely, more information is available in ependymomas of children, and commonly therapeutic strategies in adults follow those in children.

• #3 Descriptive epidemiology of ependymal tumours in the United States | British Journal of Cancer

  https://www.nature.com/articles/bjc2013221

  Ependymomas are rare primary gliomas that commonly affect both children and adults, but unique as survival is worse in children. […] The 20042009 average annual age-adjusted incidence rate of ependymal tumours was 0.41/100000. […] Overall, relative survival was favourable with rates at 85% and 75% at 3 and 10 years post diagnosis, respectively. […] However, children and adolescents, the oldest adult age group, cases diagnosed with anaplastic ependymoma and/or tumour location in a brain site had lowest survival rates. […] Paediatric cases had worse outcomes compared with adults for numerous reasons including having a higher percentage of anaplastic ependymomas and greater percentage of cases of intracranial disease. […] A total of 7303 ependymal tumours (4683 malignant and 2620 borderline malignant) were identified with an average annual age-adjusted rate (AAR) of 0.41 per 100000 (0.27, malignant and 0.15, borderline malignant).

• #4 Descriptive epidemiology of ependymal tumours in the United States | British Journal of Cancer

  https://www.nature.com/articles/bjc2013221

  Rates were higher in males than in females, whites than in other race groups and non-Hispanics compared with Hispanics. […] Among age groups, the highest rates were observed in age group 4564 years. […] Ependymoma had the highest count and AAR followed by myxopapillary ependymoma, subependymoma and anaplastic ependymoma. […] Ependymal tumours exhibit a bimodal age distribution showing a peak in the 04 year age group declining through the early adolescent years and then rising to a second peak in the 5559 year age group with the oldest age groups. […] Overall, relative survival was 93%, 85%, 80% and 75% at 1, 3, 5 and 10 years post diagnosis, respectively. […] Poorer relative survival was observed for the youngest and oldest age groups, cases diagnosed with anaplastic ependymoma and/or tumours located in the brain sites.

• #5 Ependymoma | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/ependymoma?embed_domain=hackmd.io%252F%2540yIPUAFeCSL2JsU8smR5nJQ%252Fbnjhjgjghjghjghfavicon.icofavicon.icoradiopaedia-icon-144.pngfavicon.ico&lang=us

  Overall, ependymomas have a bimodal distribution, with peaks in childhood and again later in adulthood. The incidence of different tumor types and locations varies greatly, with posterior fossa ependymomas predominating in childhood and spinal ependymomas in adulthood. […] Comparison of Epidemiology, Treatments, and Outcomes in Pediatric Versus Adult Ependymoma. Neuro-Oncology Advances. 2020;2(1):vdaa019. doi:10.1093/noajnl/vdaa019 – Pubmed. […] Incidence Patterns for Ependymoma: A Surveillance, Epidemiology, and End Results Study. JNS. 2009;110(4):725-9. doi:10.3171/2008.9.jns08117 – Pubmed.

• #6 Descriptive epidemiology of ependymal tumors in the United States.

  https://www.periodicos.capes.gov.br/index.php/acervo/buscador.html?task=detalhes&id=W2273189232

  Descriptive epidemiology of ependymal tumors in the United States. […] Ependymomas are rare tumors of the brain and spinal cord/cauda equina (SC). Population-based data from the Central Brain Tumor Registry of the United States (CBTRUS) and the Surveillance, Epidemiology, and End Results (SEER) program were used to conduct a descriptive epidemiology study of this heterogeneous subgroup of glial tumors. […] Incidence patterns were evaluated using data for malignant and nonmalignant tumors diagnosed during 2002-2006 from 17 collaborating CBTRUS registries (n = 1,733). […] Survival was examined using data for malignant ependymal tumors diagnosed in 15 SEER regions during 1992-2006 (n = 1,658). […] A bimodal age distribution showed a peak in the 0-4 year age group (0.48/100,000 p-y), declining until the early 20s and then rising to a second peak in the 55-59 year age group (0.61/100,000 p-y). […] 5- and 10-year relative survival rates for all malignant ependymal tumors were 81% and 76%, respectively, and did not differ by gender or race. […] Malignant ependymomas remain an aggressive disease, and differ in site and age of presentation to nonmalignant ependymomas.

• #7 Ependymomas – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/pediatric-cancers/ependymomas

  Ependymomas are the third most common central nervous system tumor in children (after astrocytomas and medulloblastomas), representing 10% of pediatric brain tumors (1). Mean age at diagnosis is 6 years; however, approximately 30% of ependymomas occur in children 3 years old. […] In children, ependymomas most commonly occur in the posterior fossa, followed by the supratentorial area, and then least commonly the spine (up to 10% of cases). In contrast, 60% of ependymomas in adults occur in the spine (2). […] Survival rate depends on age and on how much of the tumor can be removed: Complete or near-complete removal: 51 to 80% survival (1); Less than 90% removal: 0 to 26% survival (1).

• #8 Intracranial ependymoma and other ependymal tumors – UpToDate

  https://www.uptodate.com/contents/intracranial-ependymoma-and-other-ependymal-tumors

  Intracranial ependymomas have a peak incidence in early childhood but can occur at any age. There is a slight male predominance. The median age at diagnosis is five years, and 25 to 40 percent of patients are less than two years old. Among adults, most intracranial ependymomas occur before the age of 40 years. […] In children and young adults, ependymomas account for less than 10 percent of tumors arising in the CNS and 25 percent of primary tumors originating in the spinal cord.

• #9 Ependymoma | Concise Medical Knowledge

  https://www.lecturio.com/concepts/ependymoma/

  Intracranial ependymoma: […] – Incidence: 0.43 cases per 100,000 individuals. […] – 2.5% of all intracranial glial tumors. […] – 3rd most common pediatric brain tumor (behind medulloblastoma and pilocytic astrocytoma). […] – Age: More common in children than adults; median age at diagnosis: 45 years old; 25%-40% of patients are 2 years old; intracranial ependymoma in adults usually occurs prior to age 40. […] – Sex: slight predominance in men. […] – Location: Most commonly occurs in the posterior fossa; in children, 90% of ependymomas are intracranial. […] […] […] Spinal ependymoma: […] – Incidence: Approximately 25% of primary spinal cord tumors; in adults, 75% of ependymomas are in the spinal cord. […] – Age: More common in adults; median age at diagnosis: 30-40 years of age. […] – Location: Approximately 50% occur in the lumbosacral cord or filum terminale; approximately 50% occur elsewhere in the cervical or thoracic spinal cord.

• #10 Ependymoma: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/277621-overview

  Ependymomas are a relatively uncommon form of CNS neoplasm, representing about 3% of CNS tumors diagnosed in the United States overall. However, ependymomas comprise approximately 17% of all spinal tumors. […] Some studies have noted a slightly increased incidence of ependymoma in males vs. females. Ependymoma incidence is higher in white people than in other races. […] Epidemiological characteristics vary by ependymoma subtype. Intracranial ependymomas, particularly posterior fossa ependymomas, generally present in young children with a median age at diagnosis of 2.5 years. In one large retrospective population study, 66% of spinal tumors occurred in adults over the age of 45, and 39% of all intracranial tumors occurred in children under the age of 12.

• #11 Incidence patterns for ependymoma: a Surveillance, Epidemiology, and End Results study in: Journal of Neurosurgery Volume 110 Issue 4 (2009) Journals

  https://thejns.org/view/journals/j-neurosurg/110/4/article-p725.xml

  Previous small studies disagree about which clinical risk factors influence ependymoma incidence. […] The authors analyzed a large, population-based cancer registry to examine the relationship of incidence to patient age, sex, race, and tumor location, and to determine incidence trends over the past 3 decades. […] Data were obtained from the Surveillance, Epidemiology, and End Results (SEER-9) study, which was conducted from 1973 to 2003. […] The incidence rate per 100,000 person-years was significantly higher in male than in female patients (males 0.227 0.029, females 0.166 0.03). […] Between 1973 and 2003, the incidence increased significantly among adults but not among children, and there were no sharp changes at any single year, both before and after age adjustment. […] Males have a higher incidence of ependymoma than do females. […] Ependymoma incidence appears to have increased over the past 3 decades, but only in adults.

• #12

  https://link.springer.com/article/10.1007/s11060-019-03214-y

  The aim of this study was to identify racial/ethnic disparities with regard to survival among patients with ependymoma. […] Data from the Surveillance, Epidemiology and End Results (SEER) registry between the years of 19732015 which included 4821 patients diagnosed with ependymoma were analyzed. […] Our findings showed higher risk of mortality among non-Hispanic black patients compared to non-Hispanic white patients with ependymoma, with highest risk among pediatric patients. […] These results demonstrate significant need for research in survival outcomes for this disease. […] Data for this study were provided to the researchers from the Surveillance, Epidemiology, and End Results (SEER) Program.

• #13 Nervous system: Ependymomas

  https://atlasgeneticsoncology.org/solid-tumor/5016/nervous-system-ependymomas

  Ependymomal neoplasms are tumors of children and young adults, originating from the cerebral ventricle or from the spinal canal. In the central nervous system (CNS), they account for 3 – 9 % of all neuro-epithelial tumors. […] In children, 30 % of ependymomas appear before the age of 3 years and are more aggressive than in adults. Nearly 90 % of pediatric ependymomas are intra cranial: they occur in supratentorial or posterior fossa locations, and only 10 % are intraspinal. Ependymomas account for 6 to 12 % of brain tumors in children and represent the third most common central nervous system neoplasms in this age range, following astrocytoma and medulloblastoma. […] In adults, 60 % of ependymomas are tumors of spinal cord and only 40 % are intracranial. Intramedullary spinal ependymomas can be seen in patients with neurofibromatosis type 2 (NF2), a hereditary disease. Clustering of ependymomas has been noted in some families suggesting inheritance of a genetic susceptibility to this type of tumor.

• #14 Childhood Ependymoma Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/brain/hp/child-ependymoma-treatment-pdq

  Childhood ependymoma comprises approximately 9% of all childhood brain and spinal cord tumors, representing about 200 cases per year in the United States. […] Ependymomas arise from ependymal cells that line the ventricles and passageways in the brain and the center of the spinal cord. […] In children, 65% to 75% of ependymomas arise in the posterior fossa around the fourth ventricle. […] Surveillance neuroimaging, coupled with clinical assessments, is generally recommended after treatment for ependymoma. […] Patients whose relapsed tumor was detected by routine surveillance imaging had superior second PFS than patients whose relapsed tumor was detected by clinical symptomology. […] Most practitioners obtain MRI of the brain and/or spinal cord at the following intervals: First 2 to 3 years after treatment: Every 3 to 4 months; Four to 5 years after treatment: Every 6 months; More than 5 years after treatment: Annually because of the high incidence of late recurrences.

• #15 Spinal ependymoma | MedLink Neurology

  https://www.medlink.com/articles/spinal-ependymoma

  Ependymomas are relatively rare tumors occurring at an incidence rate of 0.43 patients per 100,000 population. They account for 1.6% of all CNS tumors, 3.1% of all malignant brain tumors, and 6.5% of all gliomas. Intracranial ependymomas generally occur in children and young adults and represent 1% to 8% of primary brain tumors. About one-third to one-half of all ependymomas arise within the spinal canal. Nearly 90% of pediatric ependymal tumors occur intracranially, and approximately 65% of adult tumors occur in the spine. Spinal ependymomas account for approximately 17% of all spinal cord tumors in adults. They represent the most common intramedullary spinal neoplasm in the adult population and account for 40% to 60% of the 2700 primary spinal cord tumors diagnosed in the United States each year. Intramedullary ependymomas are seen most frequently in the fourth decade of life and are rare below the age of 10 years. In children, older age and spinal location are predictive of improved 5-year survival. […] Based on SEER data, the incidence of ependymomas appears to have increased over the past 30 years in adults but not in children. However, spinal ependymomas associated with NF-2 seem to have an indolent course and may be observed or treated with surgery resection.

• #16 Incidence patterns for ependymoma: a surveillance, epidemiology, and end results study – PubMed

  https://pubmed.ncbi.nlm.nih.gov/19061350/

  Previous small studies disagree about which clinical risk factors influence ependymoma incidence. […] The authors analyzed a large, population-based cancer registry to examine the relationship of incidence to patient age, sex, race, and tumor location, and to determine incidence trends over the past 3 decades. […] Data were obtained from the Surveillance, Epidemiology, and End Results (SEER-9) study, which was conducted from 1973 to 2003. […] The incidence rate per 100,000 person-years was significantly higher in male than in female patients (males 0.227 +/- 0.029, females 0.166 +/- 0.03). […] Between 1973 and 2003, the incidence increased significantly among adults but not among children, and there were no sharp changes at any single year, both before and after age adjustment. […] Ependymoma incidence appears to have increased over the past 3 decades, but only in adults.

• #17 Epidemiological characteristics of myxopapillary ependymoma and factors affecting overall survival: a SEER-based analysis – Huang – Translational Cancer Research

  https://tcr.amegroups.org/article/view/93072/html

  Age, marital status, surgery and radiotherapy are factors influencing the overall survival of myxopapillary ependymoma (MPE) patients. Surgery is still the main therapeutic choice, while radiotherapy plays a negative role in the management of MPE. […] Epidemiological surveys have found that its incidence rate is 0.5-2.5 in 100,000 people per year. […] The incidence of MPE was higher among people aged 30-34 and 45-49 years old. […] No significant difference was found between the incidence of total MPE and the incidence of non-malignant MPE from 2004 to 2015, and there was no incidence trend. […] Multivariate analysis revealed that age, marital status, surgery, and radiotherapy were factors affecting both 5- and 10-year overall survival of MPE patients. […] The present study revealed that the acceptance of surgery was an important independent predictor of overall survival. […] The findings may not apply to other populations.

• #18 Anaplastic myxopapillary ependymoma: A case report and review of literature

  https://www.wjgnet.com/2218-4333/full/v12/i11/1072.htm

  Myxopapillary ependymomas (MPEs, grade I) account for 9%-13% of ependymal tumors and about 83% of ependymomas are found in the area of the filum terminale. […] Despite an overall favorable prognosis and classification as a grade I tumor, MPEs have been associated with distant metastases, subarachnoid disseminations and local late recurrences. […] In the 2016 WHO classification of central nervous system tumors, ependymal tumors are classified into the following five subtypes: MPE and subependymoma, and MPE (grade I), classic ependymoma (grade II), RELA fusion protein positive ependymoma (grade II / III) and anaplastic ependymoma (grade III). […] The mean age at manifestation is around 36 years, with a male predominance. […] Anaplastic features in glial tumors including ependymomas include frequent mitotic figures, hypercellularity, necrosis, vascular proliferation, and pleomorphologic cytoplasm and nuclei.

• #19 Ependymoma: Diagnosis and Treatment – NCI

  https://www.cancer.gov/rare-brain-spine-tumor/tumors/ependymoma

  Ependymomas occur in both children and adults. Those in the lower half of the brain (posterior fossa) are more common among children. Those in the spine are more common among adults. Ependymomas occur more often in males than females. They are most common in non-Hispanic white people. An estimated 19,340 people are living with this tumor in the United States. […] The relative five-year survival rate for ependymoma is 88.2 percent. However, many factors can affect prognosis. These include the tumor grade and molecular type, the persons age and health when diagnosed, and how they respond to treatment. If you want to understand your prognosis, talk to your doctor.

• #20 Incidence and Survival of Patients With Malignant Primary Spinal Cord Tumors: A Population-Based Analysis

  https://www.e-neurospine.org/journal/view.php?doi=10.14245/ns.2347300.650

  The 5-year observed survival and relative survival rates for the whole cohort were 82.80% and 86.00%, respectively. […] Patients diagnosed with ependymoma had significantly better survival than their counterparts. […] We conducted a population-based analysis of malignant and borderline malignant primary spinal cord tumors with the aim of revealing the epidemiology and survival of patients with primary intramedullary spinal cord tumors. […] This study provides valuable information to help us better understand the epidemiological characteristics of primary intramedullary spinal cord tumors.

• #21 Anaplastic myxopapillary ependymoma: A case report and review of literature

  https://www.wjgnet.com/2218-4333/full/v12/i11/1072.htm

  However, classification and grading of ependymomas with anaplastic features are historically controversial. […] MPEs with anaplastic features are usually locally invasive. […] They frequently tend to disseminate to other areas of the brain and spinal cord via cerebrospinal fluid (CSF), and more frequently recur with a shorter survival. […] A strong correlation was found between surgical capsule injury and recurrence. […] A 10-year OS of over 90% was recently confirmed in an epidemiology, surveillance, and outcome analysis of 773 MPE patients. […] Frequent surveillance scans of patients with MPE are recommended for early detection of recurrent disease with anaplastic features. […] Therefore, the possibility of malignant transformation of MPE should be considered, and patients with MPE should be treated carefully and monitored over a long period of time.

• #22

  https://link.springer.com/article/10.1007/s11912-022-01260-w

  A recent molecular classification has distinguished 9 subgroups of ependymomas that appear to reflect more precisely than histology alone the biological, clinical, and histopathological heterogeneity across the major anatomical compartments, age groups, and tumor grades and have represented the basis for the update of World Health Organization (WHO) classification from 2016 to 2021. […] Overall, despite the classification of ependymomas moving towards a molecular diagnosis, the WHO grading system still holds prognostic value, especially the distinction of grades 2 and 3 in intracranial ependymomas, and can help guide treatment decisions. […] Surveillance with MRI may detect recurrences in asymptomatic patients for earlier salvage therapies, resulting in superior 3-year progression free survival (PFS), but the impact on overall survival (OS) is still limited. It is still not clear how often and for how long surveillance is needed; however, due to the possibility of late recurrences, long-term follow-up is standard. […] A review of the literature on 348 patients with WHO grades 2 and 3 spinal ependymomas has shown that the extent of resection and tumor grade were independent prognostic factors for OS and PFS, and radiotherapy prolonged PFS in patients receiving STR.

• #23 Effect of radiation dose escalation on overall survival in ependymoma: A National Cancer Database analysis | Applied Radiation Oncology

  https://www.appliedradiationoncology.com/articles/effect-of-radiation-dose-escalation-on-overall-survival-in-ependymoma-a-national-cancer-database-analysis

  Ependymoma is a rare primary malignancy of the central nervous system (CNS), which has an annual incidence of approximately 2-4 new cases per million with a peak age of approximately 5 years in children and 55 years in adults. The current standard of care for management of World Health Organization (WHO) grade II/III ependymoma includes maximal feasible resection followed by radiation therapy. […] Currently, there is no randomized evidence that evaluates the effect of dose escalation above 5400 cGy on overall survival (OS) in localized ependymoma. Therefore, we sought to evaluate the effect of radiation dose escalation on OS in patients with localized ependymoma utilizing the National Cancer Data Base (NCDB). […] In this analysis of 548 patients with localized WHO grade II or III ependymoma identified from a national cancer registry, we found no difference in OS after receipt of dose-escalated radiation therapy.

• #24 Effect of radiation dose escalation on overall survival in ependymoma: A National Cancer Database analysis | Applied Radiation Oncology

  https://www.appliedradiationoncology.com/articles/effect-of-radiation-dose-escalation-on-overall-survival-in-ependymoma-a-national-cancer-database-analysis

  In conclusion, we show no OS benefit to dose-escalated radiation therapy in a population of pediatric and adult patients with localized, high-grade ependymoma identified from the NCDB. Given possible toxicities associated with dose-escalated radiation in the CNS, additional study to determine which patients may benefit from dose-escalated therapy is warranted.

• #25 Redefining germline predisposition in children with molecularly characterized ependymoma: a population-based 20-year cohort | Acta Neuropathologica Communications | Full Text

  https://actaneurocomms.biomedcentral.com/articles/10.1186/s40478-022-01429-1

  Ependymoma is the second most common malignant brain tumor in children. The etiology is largely unknown and germline DNA sequencing studies focusing on childhood ependymoma are limited. […] A meta-analysis combining our findings with pediatric pan-cancer germline sequencing studies showed an overall frequency of pathogenic germline variants of 3.4% (7/207) in children with ependymoma. In summary, less than 4% of childhood ependymoma is explained by genetic predisposition, virtually restricted to pathogenic variants in NF2 and NF1. […] We also identify new putative ependymoma predisposition genes. […] The association between neurofibromatosis type-2 and spinal ependymoma is well established and somatic NF2 variants are recurrently altered in ependymomas with intraspinal location. […] Still, pathogenic germline NF2 variants are relatively rare in the overall pediatric ependymoma population and thus explain only a minority of cases: Among the 173 children with ependymoma included in the reviewed pan-childhood cancer germline sequencing studies, only two patients (1.2%) were reported to harbor pathogenic NF2 alterations.

• #26 Redefining germline predisposition in children with molecularly characterized ependymoma: a population-based 20-year cohort | Acta Neuropathologica Communications | Full Text

  https://actaneurocomms.biomedcentral.com/articles/10.1186/s40478-022-01429-1

  Pathogenic NF1 germline variants are extremely rare among children with ependymoma. […] A likely pathogenic LZTR1 variant (p.Gln762Ter [c.2284CT]), undetected among 125,000 healthy adult in gnomAD, was found in a child diagnosed with a fourth ventricle PF-EPN-A1c ependymoma. […] This population-based germline sequencing study of childhood ependymoma, including constrained gene analysis, establishes that genetic predisposition plays a role for less than 4% of patients.

• #27 Surveillance neuroimaging in childhood intracranial ependymoma: how effective, how often, and for how long? in: Journal of Neurosurgery Volume 94 Issue 1 (2001) Journals

  https://thejns.org/view/journals/j-neurosurg/94/1/article-p27.xml

  The authors examined images obtained in 52 children with intracranial ependymomas to determine risk factors for tumor recurrence and to assess the impact of surveillance imaging on patient outcome. […] Surveillance imaging reveals a substantial number of asymptomatic recurrences, and survival appears to be improved in these patients compared with those identified by symptoms. The improvement in survival is thought to be greater than that expected just from earlier diagnosis.

• #28 Spinal myxopapillary ependymoma with interval drop metastasis presenting as cauda equina syndrome: case report and review of literature – Rege – Journal of Spine Surgery

  https://jss.amegroups.org/article/view/3600/4322

  The most common presenting symptoms of spinal MPE include pain, weakness, and sensory changes. Symptoms of bowel, bladder, and/or sexual dysfunction may be seen depending on the tumor location. MPE is a benign tumor but has various growth patterns and metastatic modes. Metastatic spread of MPE is infrequent and, when it does occur, the disease tends to spread in the rostral direction within the central nervous system. Intracranial metastasis is the most common site for MPE spread. A recent review described 19 such cases and found a variety of intracranial sites involved including the telencephalon, the brainstem, and the cerebellum. The time span to presentation of metastasis also varied wildly, from 1 month to 13 years following primary tumor resection in one series. […] The various cases mentioned in the recent literature suggest a higher incidence of CNS dissemination of MPEs than previously thought. This holds true at the time of diagnosis and during the subsequent follow up. Screening of the entire CNS axis at the time of diagnosis and during follow up is recommended. The limited data on treatment of MPE indicates, radiotherapy is efficacious for residual tumor following subtotal resection and for metastatic disease. Long-term survival has been documented in MPE patients though continued follow up is warranted to look for interval metastasis.

• #29 Incidence and Survival of Patients With Malignant Primary Spinal Cord Tumors: A Population-Based Analysis

  https://www.e-neurospine.org/journal/view.php?doi=10.14245/ns.2347300.650

  Epidemiological studies on spinal cord tumors are rare, and studies on primary intramedullary tumors are even rarer. […] The incidence and survival of patients with primary intramedullary spinal cord tumors have not been well documented. […] We aimed to study the incidence and survival of patients with primary spinal cord malignant and borderline malignant tumors based on data from the Surveillance, Epidemiology, and End Results (SEER) database and provide information for revealing the epidemiology and exploring the prognosis of patients with primary intramedullary tumors. […] The age-adjusted incidence rates of primary spinal cord ependymoma was 0.18 per 100,000. […] The incidence rate of ependymoma was significantly higher than that of other pathological types. […] The incidence rate was highest in Caucasian.

• #30

  https://journals.lww.com/annals-of-medicine-and-surgery/fulltext/2025/05000/exploring_neonatal_brain_tumors__a_narrative.38.aspx

  NBTs have an incidence rate of 0.51% in neonates. […] However, some variations may occur due to differences in diagnostic procedures between countries and a lack of pediatric data in some regions. […] An interaction between genetic, environmental, and demographic factors modulates their prevalence. […] Researchers have recognized multiple risk factors, such as ionizing radiation exposure, genetic abnormalities, birth defects, prenatal growth indicators, advanced parental age, and maternal consumption of N-nitroso compounds. […] Understanding these multiple epidemiological determinants is crucial for improving prevention, diagnosis, and treatment modalities for newborns. […] The incidence of different subtypes was heterogeneous within different series and related to racial and regional factors. […] Sexual disparities are noted, in which males are more likely to develop choroid plexus, embryonal, and ependymal tumors than females.

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