Clinical presentation and outcomes for adult ependymoma patients

Cancer. 2017 Feb 1;123(3):494-501. doi: 10.1002/cncr.30355. Epub 2016 Sep 28.

Abstract

Background: Outcomes projects can be a catalyst for determining disease- and treatment-related consequences for patients with rare tumors. The Adult Ependymoma Outcomes (AEO) survey uses self-reported experience to evaluate how this tumor affects patient groups throughout the illness trajectory.

Methods: Patients completed the AEO survey via a Web-based portal. The survey included questions on treatment, tumor recurrence, and current health status; the MD Anderson Symptom Inventory Brain Tumor and Spine Tumor modules; and the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36).

Results: The sample included 264 participants (57% female) with a median age of 46 years (range, 18-77 years). Radiation treatment was commonly used for patients who had brain involvement (χ2 (1) = 20.7; P < .001), underwent a partial resection (43%; χ2 (3) = 15.4; P < .001), or had a grade 3 tumor (41%; χ2 (2) = 18.8; P < .001). Recurrence occurred in a small group (29%), with grade 1 tumor patients 2.6 times more likely and grade 3 tumor patients 2.5 times more likely to experience recurrence than those with grade 2 tumors. Spine tumor patients had a higher symptom burden (mean, 2.8; scale, 0-10) than brain tumor patients (t(247) = -4.0), and they reported more moderate to severe symptoms (rating ≥ 5; 29%) than their counterparts (18%). Within the physical health portion of the SF-36, spine tumor patients reported worse health with respect to bodily pain (t(249) = 6.8; P < .001), physical functioning (t(252) = 4.1; P < .001), and vitality (t(202.2) = 3.0; P < .003).

Conclusions: These results demonstrate the feasibility of implementing outcomes projects that report on the clinical and demographic characteristics of a rare patient population, and they underscore the importance of outcomes data in understanding disease-related issues. Cancer 2017;123:494-501. © 2016 American Cancer Society.

Keywords: cancer treatment; central nervous system; ependymoma; quality of life; symptoms.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Brain Neoplasms / epidemiology*
  • Brain Neoplasms / pathology
  • Brain Neoplasms / therapy
  • Ependymoma / epidemiology*
  • Ependymoma / pathology
  • Ependymoma / therapy
  • Female
  • Health Status
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / epidemiology*
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / therapy
  • Outcome Assessment, Health Care
  • Quality of Life
  • Spinal Cord Neoplasms / epidemiology*
  • Spinal Cord Neoplasms / pathology
  • Spinal Cord Neoplasms / therapy
  • Surveys and Questionnaires
  • Young Adult