Neurologic Manifestations of Ependymoma Follow-up

Updated: Mar 19, 2019
  • Author: Subrata Ghosh, MD, MBBS, MS; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
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Follow-up

Further Outpatient Care

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  • Radiation therapy

  • Chemotherapy

  • Serial neuroimaging (MRI)

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Further Inpatient Care

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  • Admit the patient for repeat surgery.

  • Admit the patient for treatment of complications from surgery, radiotherapy, or chemotherapy.

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Complications

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  • Hydrocephalus

  • Paralysis

  • Cranial nerve palsy

  • Meningitis

  • Bone marrow suppression

  • Cognitive dysfunction

  • Growth and developmental delay

  • Hypothyroidism

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Prognosis

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  • Gross total resection is the most important determinant of outcome, with progression-free survival rates of 70-80% after 5 years, compared to 35% for incomplete resection. [9]

  • Postoperative radiation therapy improves survival, whereas results of chemotherapy are disappointing. [6]

  • Age also strongly correlates with outcome. Usually, the younger the patient, the worse the prognosis.

  • In addition to age, supratentorial tumor location is associated with a worse prognosis in adult ependymoma patients. Supratentorial location was also correlated with shorter progression-free survival than infratentorial location in a multicenter retrospective analysis. [10]

  • Studies in which the current WHO classification criteria were applied reported the relationship between histological grade and outcome. Biomolecular studies have identified that gain of 1q25 and epidermal growth factor receptor (EGFR) overexpression correlate to poor prognosis, whereas low expression of nucleolin correlated with a favorable outcome. [11]

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Patient Education

Refer the patient for psychosocial counseling.

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