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Verfasst von:Benesch, Martin [VerfasserIn]   i
 Mynarek, Martin [VerfasserIn]   i
 Witt, Hendrik [VerfasserIn]   i
 Warmuth-Metz, Monika [VerfasserIn]   i
 Pietsch, Torsten [VerfasserIn]   i
 Bison, Brigitte [VerfasserIn]   i
 Pfister, Stefan [VerfasserIn]   i
 Pajtler, Kristian Wilfried [VerfasserIn]   i
 Kool, Marcel [VerfasserIn]   i
 Schüller, Ulrich [VerfasserIn]   i
 Pietschmann, Klaus [VerfasserIn]   i
 Juhnke, Björn-Ole [VerfasserIn]   i
 Tippelt, Stephan [VerfasserIn]   i
 Fleischhack, Gudrun [VerfasserIn]   i
 Schmid, Irene [VerfasserIn]   i
 Kramm, Christof M. [VerfasserIn]   i
 Vorwerk, Peter [VerfasserIn]   i
 Beilken, Andreas [VerfasserIn]   i
 Classen, Carl Friedrich [VerfasserIn]   i
 Hernáiz Driever, Pablo [VerfasserIn]   i
 Kropshofer, Gabriele [VerfasserIn]   i
 Imschweiler, Thomas Alfred Karl [VerfasserIn]   i
 Lemmer, Andreas [VerfasserIn]   i
 Kortmann, Rolf-Dieter [VerfasserIn]   i
 Rutkowski, Stefan [VerfasserIn]   i
 Hoff, Katja von [VerfasserIn]   i
Titel:Newly diagnosed metastatic intracranial ependymoma in children
Titelzusatz:frequency, molecular characteristics, treatment, and outcome in the prospective HIT series
Verf.angabe:Martin Benesch, Martin Mynarek, Hendrik Witt, Monika Warmuth‐Metz, Torsten Pietsch, Brigitte Bison, Stefan M. Pfister, Kristian W. Pajtler, Marcel Kool, Ulrich Schüller, Klaus Pietschmann, Björn-Ole Juhnke, Stephan Tippelt, Gudrun Fleischhack, Irene Schmid, Christof M. Kramm, Peter Vorwerk, Andreas Beilken, Carl Friedrich Classen, Pablo Hernáiz Driever, Gabriele Kropshofer, Thomas Imschweiler, Andreas Lemmer, Rolf-Dieter Kortmann, Stefan Rutkowski, Katja von Hoff
E-Jahr:2019
Jahr:March 8, 2019
Umfang:9 S.
Fussnoten:Gesehen am 07.11.2019
Titel Quelle:Enthalten in: The oncologist
Ort Quelle:Hoboken, NJ : Wiley, 1996
Jahr Quelle:2019
Band/Heft Quelle:24(2019), 9, Seite e921-e929
ISSN Quelle:1549-490X
Abstract:Background. Data on frequency, clinical presentation, and outcome of primary metastatic intracranial ependymoma in children are scarce. - Patients and Methods. Prospective data on patients younger than 21 years with metastatic intracranial ependymoma at first diagnosis, registered from 2001 to 2014 in the HIT‐2000 trial and the HIT‐2000 Interim Registry, were analyzed. - Results. Of 453 registered patients with intracranial ependymoma and central neuropathology review, initial staging included spinal magnetic resonance imaging in all patients and lumbar cerebrospinal fluid (CSF) analysis in 402 patients. Ten patients (2.2%) had metastatic disease, including three with microscopic CSF positivity only (M1 metastasis stage, 0.7% of patients with CSF staging). Location of the primary tumor was supratentorial in four patients (all supratentorial RELA‐fused ependymoma [ST‐EPN‐RELA]) and within the posterior fossa in five patients (posterior fossa ependymoma type A [PF‐EPN‐A], n = 4; posterior fossa ependymoma not further classifiable, n = 1), and multifocal in one patient. All four patients with ST‐EPN‐RELA were alive in first or second complete remission (CR) 7.5-12.3 years after diagnosis. All four patients with macroscopic metastases of posterior fossa or multifocal ependymoma died. Three patients with initial M1 stage (ST‐EPN‐RELA, n = 1; PF‐EPN‐A, n = 2) received chemotherapy and local irradiation and were alive in second or third CR 3.0-9.7 years after diagnosis. Progression‐free and overall survival of the entire cohort at 5 years was 13% (±6%), and 58% (±16%), respectively. - Conclusion. Primary metastatic disease is rare in children with intracranial ependymoma. Prognosis may depend on molecular subgroup and extent of dissemination, and relevance of CSF analysis for initial staging remains to be clarified. - Implications for Practice. Childhood ependymoma presenting with metastasis at first diagnosis is very rare with a frequency of 2.4% in this population‐based, well‐characterized cohort. Detection of microscopic metastases in the cerebrospinal fluid was extremely rare, and impact on prognosis and respective treatment decision on irradiation field remains unclear. Initial metastatic presentation occurs in both supratentorial RELA‐fused ependymoma and posterior fossa ependymoma. Prognosis may differ according to extent of metastasis and biological subgroup, with poor prognosis in diffusely spread metastatic posterior fossa ependymoma even after combination therapy with both intensive chemotherapy and craniospinal irradiation, which may help to guide individual therapeutic decisions for future patients.
DOI:doi:10.1634/theoncologist.2018-0489
URL:Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.

Resolving-System: https://theoncologist.onlinelibrary.wiley.com/doi/10.1634/theoncologist.2018-0489
 Verlag: http://theoncologist.alphamedpress.org/content/24/9/e921
 DOI: https://doi.org/10.1634/theoncologist.2018-0489
Datenträger:Online-Ressource
Sprache:eng
Sach-SW:Children
 Intracranial ependymoma
 Metastases
 Molecular subgroups
 Therapy
K10plus-PPN:1681388405
Verknüpfungen:→ Zeitschrift

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