Outcome for Infratentorial Ependymomas in Children

  • 40–60% 5-year survival: The functional outcomes for children with an infratentorial ependymoma have improved with recent progress in surgical intervention, neuroimaging, and radiotherapy. Overall, 5-year survival rates range from 40– 60%.
  • Survival dependent on resection: The most important prognostic factor is the extent of surgical resection, as longer survival periods are associated with complete tumor removal. Long-term survival is related to the amount of residual tumor revealed by postoperative MRI. Residual enhancing tissue on MRI scans after completion of radiotherapy should be explored and resected if deemed safely resectable.
  • Young age and metastases predict poor outcome: Children under the age of 3 years with leptomeningeal spread despite multimodality treatment have worse outcomes.
  • Anaplasia: High mitotic index is associated with worse prognosis, but histological classification does not reflect different survival rates between infratentorial ependymomas and anaplastic infratentorial ependymomas (19).