Prognosis

Operative mortality for ependymal tumors currently is probably on the order of 10 or 15 percent, but older published figures include operative mortalities of over 30 percent. The best survivals are in those patients who have an operation to remove as much of the tumor as possible, followed by radiation therapy, Postoperative radiation doubles the 5-year survival relative to operation alone. In general. the 5-year survival is expected to be 50 to 60 percent and the 10-year survival is expected to be 40 to 50 percent. Salazar et al. reported a 10-year survival of 69 percent (75 percent for low-grade tumors and 67 percent for high-grade tumors). Phillips et al. reported a 5-year survival of 80 percent in those with supratentorial tumors and a 5-year survival of 90 percent in those with infratentorial tumors: these figures were for patients who had received -+500 rad or more.

The two most important prognostic factors for survival are: (1) tumor grade and (2) presence of residual tumor on postoperative radiological studies. Survival rates are significantly reduced in patients with high-grade tumors and in patients with residual tumor noted on magnetic resonance imaging or computed tomography following operation.