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Extraventricular site indicates higher grade but better prognosis in adult supratentorial ependymomas: a 14-year single-center retrospective cohort

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Abstract

Supratentorial extraventricular ependymoma (STEE) and supratentorial intraventricular ependymoma (STIE) are two subsets of supratentorial ependymoma (SE). These two subsets have similar gene features and only differ in original sites: STEE occurs in the brain parenchyma, and STIE is located in ventricles and surrounded by cerebral spinal fluid. The present study aims to depict the diversities of these two subsets and elucidate the potential effects of the anatomic site on the tumor with the same type, grade, and molecular features. Sixty-six consecutive adult SE patients from 2008 to 2021 were enrolled in our study. Clinical data, pathological features, and long-term outcomes were analyzed retrospectively. Results demonstrated that adult STEE presented with a higher proportion of WHO grade 3 (P = .028) and higher Ki-67 index (≥10%) (P = .019) compared to adult STIE. Survival analysis demonstrated that patients of grade 3 STEE exhibited a significantly longer overall survival (OS) than patients of grade 3 STIE (median OS, 24.4 months vs. 13.0 months; P = .004). Grade 2 (hazard ratio (HR) = 0.217; P < .001) and gross total resection (GTR) (HR = 0.156; P < .001) were identified as favorable prognostic factors for all adult SE. The STEE was also associated with a lesser hazard of death for patients of grade 3 on multivariate analysis (HR = 0.263; P = .047). These findings suggested that the extraventricular site was an indicator for higher grade and better prognosis in adult supratentorial ependymoma.

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All relevant data are available from the corresponding authors on reasonable request.

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Acknowledgements

The authors thank the staff from the Department of Neurosurgery, West China Hospital, Sichuan University for their support and for clinical data collection.

Funding

This work was supported by a grant from Sichuan Province Science and Technology Support Program (2017SZ0006 to YL), Post-Doctor Research Project, West China Hospital, Sichuan University (Grant No. 2021HXBH010 to TL and Grant No. 2020HXBH159 to MZ).

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  1. Siliang Chen and Mingrong Zuo contributed equally to this work.

Authors and Affiliations

  1. Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, People’s Republic of China

    Siliang Chen, Mingrong Zuo, Tengfei Li, Shuxin Zhang, Wanchun Yang, Qing Mao & Yanhui Liu

  2. Neuroscience & Metabolism Research, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, People’s Republic of China

    Siliang Chen, Mingrong Zuo, Tengfei Li, Wanchun Yang & Mina Chen

  3. Department of Pathology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, People’s Republic of China

    Ni Chen

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Contributions

All authors contributed to the study conception and design. YL, MC, SC, MZ, and TL designed the study. SC, MZ, and TL wrote the manuscript. SC, MZ, SZ, and TL collected and analyzed clinical and follow-up data. NC reviewed the pathological diagnosis of all cases. All authors read and approved the final manuscript.

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Correspondence to Mina Chen or Yanhui Liu.

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Clinical data collection and use were performed strictly with ethics regulations and approved by the institutional review board of West China Hospital based on local ethics regulations and the 1964 Helsinki declaration and its later amendments. All patients signed written consent for clinical data collection and use.

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The authors affirm that human research participants provided informed consent for the publication of the images in Fig. 1.

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Chen, S., Zuo, M., Li, T. et al. Extraventricular site indicates higher grade but better prognosis in adult supratentorial ependymomas: a 14-year single-center retrospective cohort. Neurosurg Rev 45, 3771–3778 (2022). https://doi.org/10.1007/s10143-022-01885-2

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