Abstract 17389: Antiplatelets Agents Decreases 30-days Mortality in Myocardial Injury After Noncardiac Surgery

Introduction: Despite being frequent and associated with poor outcomes, no guidelines exist addressing the management of myocardial injury after noncardiac surgery (MINS). We hypothesized that Antiplatelets (ATP) agents reduce 30-days mortality in MINS patients. Methods: We used data from the Wake-Up T2MI registry, which is a single-center, retrospective cohort of hospitalized adults with elevated troponin (cTn) I (> 99 th percentile reference upper limit is >0.04 ng/dL) without acute myocardial infarction in a 2-year period. Patients with the cardiac procedures were excluded and cTn obtained during hospitalization. MINS is defined as abnormally elevated cTn levels during or within 30 days after surgery. Kaplan-Meier curve and multivariate-adjusted Cox-proportional hazard models were performed to assess all-cause mortality at 30-days, 90-days, and 1-year among patients with and without ATPs upon discharge. Results: A total of 457 patients were included in the final analysis. There was no difference in sex, race, BMI, and peak cTn, except age among patients stratified by ATP on discharge. Prevalence of mortality was significantly lower at 30-days (2.6% vs 7%, p = 0.028), it was not significant at 90-days (9.6% vs. 11.8%, p = 0.440) and at 1-year (21.4% vs. 24.6%, p=0.421) in patients who were discharged on ATPs compared to non-ATPs. Survival benefit was significant at 30-days (log-rank p = 0.022), non-significant at 90-days (log-rank p = 0.292) and at 1-year (log-rank p = 180) in ATPs group compared to non-ATPs. In a multivariate-adjusted (adjusted for age, sex, race, and peak cTn) model, patients who were discharged on ATPs had a HR of 0.31 (0.120 - 0.799; p = 0.015) at 30 days, HR of 0.64 (0.363 - 1.136; p = 0.128) at 90 days (Figure 1), and HR of 0.69 (0.472 - 1.025; p = 0.066) at 1 year. Conclusions: In conclusion, antiplatelet agents on discharge were associated with decreased 30-days mortality in MINS patients. Further studies are needed to validate our results.

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Abstract 17068: Do Post-Operative Nitrates Increase Mortality in Non-Cardiac Surgery Patients With Perioperative Myocardial Injury?

Circulation ◽

10.1161/circ.142.suppl_3.17068 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Harsh R Barot ◽

Parag A Chevli ◽

Abhishek Dutta ◽

Padageshwar Sunkara ◽

Geeth Sandeep Nadella ◽

...

Keyword(s):

Large Scale ◽

Myocardial Injury ◽

Final Analysis ◽

Isosorbide Mononitrate ◽

Coronary Syndrome ◽

Cardiac Procedures ◽

Kaplan Meier ◽

Significant Difference ◽

Cox Proportional Hazard Models ◽

Adjusted Model

Introduction: Myocardial injury after noncardiac surgery (MINS) is strongly associated with 30-day mortality, and data on its management is scarce. We hypothesized that postoperative nitrates (Isosorbide mononitrate, Isosorbide dinitrate, and scheduled Nitroglycerine) increase mortality in MINS patients. Methods: We used data from the Wake-Up T2MI registry, which is a single center, retrospective cohort of adults with elevated troponin (cTn) I (>0.04 ng/dL) during hospitalization without acute coronary syndrome in a 2-year period (2009-2010). Cardiac procedures were excluded. Kaplan-Meier curves and a multivariate-adjusted Cox-proportional hazard models were performed to assess all-cause mortality at 90-days and 1-year among patients with and without nitrates upon discharge. Results: Total of 457 MINS patients were included in the final analysis. There was no significant difference in baseline characteristics and peak cTn among patients stratified by nitrates status. Prevalence of mortality in the nitrates group was significantly higher at 90-days (35.7% vs 10%, p = 0.002) and non-significantly higher at 1-year (42.9% vs. 22.4%, p = 0.073) compared to non-nitrates group. Survival benefit was significantly lower in the nitrates group at 90-days (log-rank p = 0.002) and at 1-year (log-rank p = 0.031) (Figure 1). In a multivariate-adjusted model, nitrates had a HR of 3.032 (1.018 - 9.026; p = 0.046) at 90-days and HR of 2.022 (0.809 - 5.054; p = 0.132) at 1-year (Figure 2). Conclusion: Nitrates on discharge were associated with increased mortality at 3-months and at 1-year in MINS patients. Further large-scale studies are required to validate our results.

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LAMB1 Is Related to the T Stage and Indicates Poor Prognosis in Gastric Cancer

Technology in Cancer Research & Treatment ◽

10.1177/15330338211004944 ◽

2021 ◽

Vol 20 ◽

pp. 153303382110049

Author(s):

Tao Ran ◽

ZhiJi Chen ◽

LiWen Zhao ◽

Wei Ran ◽

JinYu Fan ◽

...

Keyword(s):

Gastric Cancer ◽

Poor Prognosis ◽

Hazard Models ◽

Proportional Hazard ◽

Kegg Analysis ◽

Proportional Hazard Models ◽

Cox Proportional Hazard ◽

Kaplan Meier ◽

Cox Proportional Hazard Models ◽

Gastric Cancer Patients

Background and Objective: Gastric cancer (GC) is a common tumor malignancy with high incidence and poor prognosis. Laminin is an indispensable component of basement membrane and extracellular matrix, which is responsible for bridging the internal and external environment of cells and transmitting signals. This study mainly explored the association of the LAMB1 expression with clinicopathological characteristics and prognosis in gastric cancer. Methods: The expression data and clinical information of gastric cancer patients were downloaded from The Cancer Genome Atlas (TCGA) and Asian Cancer Research Group (ACRG). And we analyzed the relationship between LAMB1 expression and clinical characteristics through R. CIBERSORTx was used to calculate the absolute score of immune cells in gastric tumor tissues. Then COX proportional hazard models and Kaplan-Meier curves were performed to evaluate the role of LAMB1 and its influence on prognosis in gastric cancer patients. Finally, GO and KEGG analysis were applied for LAMB1-related genes in gastric cancer, and PPI network was constructed in Cytoscape software. Results: In the TCGA cohort, patients with gastric cancer frequently generated LAMB1 gene copy number variation, but had little effect on mRNA expression. Both in the TCGA and ACRG cohorts, the mRNA expression of LAMB1 in gastric cancer tissues was higher than it in normal tissues. All patients were divided into high expression group and low expression group according to the median expression level of LAMB1. The elevated expression group obviously had more advanced cases and higher infiltration levels of M2 macrophages. COX proportional hazard models and Kaplan-Meier curves revealed that patients with enhanced expression of LAMB1 have a worse prognosis. GO/KEGG analysis showed that LAMB1-related genes were enriched in PI3K-Akt signaling pathway, focal adhesion, ECM-receptor interaction, etc. Conclusions: The high expression of LAMB1 in gastric cancer is related to the poor prognosis of patients, and it may be related to microenvironmental changes in tumors.

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Prognostic implications of depression and inflammation in patients with metastatic lung cancer

Future Oncology ◽

10.2217/fon-2020-0632 ◽

2020 ◽

Author(s):

Daniel C McFarland ◽

Rebecca M. Saracino ◽

Andrew H. Miller ◽

William Breitbart ◽

Barry Rosenfeld ◽

...

Keyword(s):

Lung Cancer ◽

Hazard Ratio ◽

Proportional Hazard ◽

Metastatic Lung Cancer ◽

Proportional Hazard Models ◽

Cox Proportional Hazard ◽

Kaplan Meier ◽

Metastatic Lung ◽

Cox Proportional Hazard Models ◽

Prognostic Implications

Background: Lung cancer-related inflammation is associated with depression. Both elevated inflammation and depression are associated with worse survival. However, outcomes of patients with concomitant depression and elevated inflammation are not known. Materials & methods: Patients with metastatic lung cancer (n = 123) were evaluated for depression and inflammation. Kaplan–Meier plots and Cox proportional hazard models provided survival estimations. Results: Estimated survival was 515 days for the cohort and 323 days for patients with depression (hazard ratio: 1.12; 95% CI: 1.05–1.179), 356 days for patients with elevated inflammation (hazard ratio: 2.85, 95% CI: 1.856–4.388), and 307 days with both (χ2 = 12.546; p < 0.001]). Conclusion: Depression and inflammation are independently associated with inferior survival. Survival worsened by inflammation is mediated by depression-a treatable risk factor.

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Abstract 16571: The Potential Impact of Expanding Cardiac Rehabilitation Coverage in Heart Failure: Insights From Get With the Guidelines Heart Failure

Circulation ◽

10.1161/circ.132.suppl_3.16571 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Jacob P Kelly ◽

Brad G Hammill ◽

Jacob A Doll ◽

G. Michael Felker ◽

Paul A Heidenreich ◽

...

Keyword(s):

Heart Failure ◽

Cardiac Rehabilitation ◽

Adverse Outcomes ◽

P Value ◽

Proportional Hazard ◽

Cox Proportional Hazard ◽

Kaplan Meier ◽

Cox Proportional Hazard Models ◽

Expanded Criteria ◽

Get With The Guidelines

Background: In February 2014, coverage for cardiac rehabilitation (CR) was expanded by Centers for Medicare & Medicaid to include patients with chronic symptomatic heart failure (HF) on optimal medical therapy with ejection fraction <35%. Thus, we sought to characterize the patient population newly eligible for CR based on the expanded criteria and their associated outcomes. Methods: We analyzed the Get With The Guidelines-HF registry linked to Medicare claims data from 2008-2012 to assess three groups of patients age 65 or older: previously eligible (due to prior MI, CABG, stable angina, heart valve surgery, or PCI in the previous 12 months), newly eligible, and ineligible for CR. Ineligible patients met neither criteria. Incidence rate was calculated with Kaplan-Meier estimates and Cox proportional hazard models were used to determine the association of events. Results: Among 51,665 HF patients discharged alive, 27.2% (n=14,053) were newly eligible and 14.5% were previously eligible for CR (n=7477). Newly eligible patients were more likely to be black, have atrial fibrillation and EF < 35%, while having fewer previous hospitalizations than patients previously eligible for CR. Newly eligible and ineligible patients had similar risk for 1-year mortality compared with those previously eligible (adjusted Hazard Ratio [HR] 0.95, 95% Confidence Interval [CI] 0.88-1.02, p-value=0.13 and [HR] 1.05, 95% [CI] 0.98-1.13, p-value=0.17, respectively). However, newly eligible and ineligible patients had lower risk for 1-year readmission compared with those previously eligible (adjusted [HR] 0.89, 95% [CI] 0.85-0.93, p-value<0.001 and [HR] 0.94, 95% [CI] 0.90- 0.98, p-value<0.001). Conclusions: The extension of coverage for cardiac rehabilitation has tripled the potentially eligible HF population. As these newly eligible patients are at high risk for adverse outcomes, cardiac rehabilitation should be considered.

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Treatment outcome of acute myeloid leukemia (AML) in HIV+ patients.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.6595 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 6595-6595

Author(s):

Irene Ang Dy ◽

Matthew Patchett ◽

Alicia McDonald ◽

Peter H. Wiernik

Keyword(s):

Median Survival ◽

Myeloid Leukemia ◽

Final Analysis ◽

Cd4 Count ◽

Proportional Hazard ◽

Consolidation Therapy ◽

Hiv Patients ◽

Cox Proportional Hazard ◽

Kaplan Meier ◽

Acute Myeloid

6595 Background: AML is diagnosed more frequently in HIV+ patients than previously. The results with standard AML treatment in such patients have not been evaluated. We evaluated whether the results justify standard aggressive treatment of AML in HIV+ patients. Methods: We identified 5 HIV+ patients at our institution who were subsequently diagnosed with AML and 68 previously reported HIV+ patients with AML through PubMed from 1986-2011. The median age at the time of AML diagnosis was 40 years (range 7-70 years). Of the 26 patients with known karyotype, 7 had favorable, 7 intermediate and 12 had unfavorable cytogenetics. The majority of treated patients received standard intensive induction therapy and complete responders (CR) received consolidation therapy. HIV was pre-, post-, and concurrently diagnosed in 47, 2 and 19 AML patients respectively. The Kaplan-Meier method examined whether CD4 count, AML treatment and CR attainment affected overall survival. Cox proportional hazard modeling, adjusted for age and CD4 count determined whether AML treatment and CR attainment were associated with death from AML. Results: The final analysis included pre- and concurrently HIV diagnosed AML patients (n=66). HIV infection occurred at a median of 5 years (range 0.25-28 years) prior to the diagnosis of AML in 47 patients. The most common FAB types were M4 (22.6%) and M2 (22.6%). CR was achieved in 71.7% (n=33/46) of treated patients and 51.5% (n=17/33) of them relapsed with a median CR duration of 9.2 months. Median survival of patients with CD4 count < 200 and ≥ 200 was 7 vs. 13.4 months (p=0.03); median survival of untreated and treated patients was 1.0 vs.13.2 months (p < 0.001) and median survival of treated patients who did and did not achieve CR was 2 vs. 21 months respectively (p < 0.001). All treated patients and those who achieved CR were less likely to die from AML than untreated patients and those who failed to respond (H.R=0.05; 95% CI, 0.01-0.17 and H.R. = 0.11; 95% C.I, 0.04-0.35, respectively). Conclusions: Standard AML treatment and CR were associated with longer survival in HIV+ patients regardless of CD4 count. More than half of patients studied achieved CR. HIV+ AML patients should be offered standard AML therapy.

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Abstract 208: Periprocedural Stroke and Myocardial Infarction as Risks for Long-term Mortality in CREST

Stroke ◽

10.1161/str.48.suppl_1.208 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Michael R. Jones ◽

Gary S. Roubin ◽

Wayne M. Clark ◽

Ariane Mackey ◽

Joseph Blackshear ◽

...

Keyword(s):

Myocardial Infarction ◽

Preventive Treatment ◽

Proportional Hazard ◽

Carotid Revascularization ◽

Cox Proportional Hazard ◽

Kaplan Meier ◽

Cox Proportional Hazard Models ◽

The Relationship ◽

Long Term Mortality

Introduction: Occurrence of stroke and myocardial infarction (MI) after carotid endarterectomy or stenting have each been associated with increased later mortality. Methods: In the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) 69 strokes, 37 protocol MIs, and 19 biomarker + only events occurred within 30 days among 2272 patients followed up to 10 years. Mortality was determined and compared for patients with stroke, MI, or biomarker + only to those without. Cox proportional hazard models adjusting for age, sex, symptomatic status and treatment were calculated to assess the relationship between mortality and stroke and mortality and MI status. Kaplan-Meier survival curves were plotted. Results: Patients with peri-procedural stroke had a 67% greater likelihood of long-term mortality compared to those without stroke (HR=1.67, 95% CI 1.15,2.43; p<0.007)(Figure A). Patients with a protocol MI had a 249% greater likelihood of mortality, and biomarker+ only patients had a 104% greater likelihood of mortality, compared to those without MI (HR=3.49; 95%CI 2.20,5.53, p<0.0001; and HR=2.04; 95% CI 1.09,3.83, p=0.03)(Figure B). Discussion: Stroke, MI, and biomarker + only events following CEA or CAS are associated with increased long-term mortality. The higher risk for MI may be a marker for patients with serious underlying heart disease, rather than causal, providing an opportunity to decrease long-term mortality through aggressive diagnostic evaluation and preventive treatment.

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Outcomes after treatment of resectable, node-negative esophageal cancer: A risk-adjusted analysis of the Surveillance, Epidemiology, and End Results registry.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.e14562 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. e14562-e14562

Author(s):

Jeremiah Thomas Martin ◽

Mathias Worni ◽

Joseph Bertram Zwischenberger ◽

Ricardo Pietrobon ◽

Thomas A. D'Amico ◽

...

Keyword(s):

Esophageal Cancer ◽

Tumor Resection ◽

Proportional Hazard ◽

Nodal Disease ◽

Node Negative ◽

T Stage ◽

Cox Proportional Hazard ◽

Kaplan Meier ◽

Cox Proportional Hazard Models ◽

Survival Risk

e14562 Background: Esophageal cancer has poor prognosis even in early stages. We examined survival for patients with resectable tumors in the absence of nodal disease in order to assess the benefits of surgery and radiation. Methods: Patients with T1-T3N0M0 squamous cell or adenocarcinoma of the mid or distal esophagus were identified using the SEER database from 1998-2008. The Kaplan-Meier approach and risk-adjusted Cox proportional-hazard models were used to assess 5-year overall survival. Survival risk among treatment modality subgroups (surgery only (SO), radiotherapy only (RO), combined surgery and radiotherapy (CT), and local tumor resection (LR)) was evaluated for the overall patient cohort and stratified among T-stage. SEER does not record chemotherapy use, which therefore wasn’t analyzed. Results: Overall 5-year survival for 4,251 patients identified (mean age 67.7±11.4 years, 966 (22.7%) female) was 37.6% (95% CI: 35.8-39.4). Survival correlated with T-stage: T1N0 48.0% (45.4-50.6); T2N0 29.8% (26.1-33.5); and T3N0 25.8% (22.9-28.7), p<0.001. For T1N0 patients, risk-adjusted survival was better with SO compared to CT (HR: 0.84, CI: 0.74-0.96, p=0.01) while LR and SO were not significantly different (p=0.24) (Table). Treatment with SO or CT had better survival compared to RO for T2N0 and T3N0 patients. The addition of radiation to surgery (CT vs. SO) improved survival for T3N0 patients (HR 0.79, CI 0.65-0.97, p=0.03) but not T2N0 patients (HR: 1.05, CI: 0.81-1.37, p=0.71). Conclusions: Surgical resection without radiation therapy is adequate for T1N0 esophageal cancer, but combined radiation and surgery has the best outcomes for T3N0 patients. Prognoses of T2N0 cancers are more similar to T3N0 cancers than T1N0 cancers, but no survival benefit to adding radiation to surgery for T2N0 patients was seen in this study. [Table: see text]

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Overexpression of fibulin-3 in tumor tissue predicts poor survival of malignant mesothelioma patients from hand-spinning asbestos exposed area in eastern China

Scientific Reports ◽

10.1038/s41598-020-77412-4 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Zhaoqiang Jiang ◽

Wei Shen ◽

Shibo Ying ◽

Zhibin Gao ◽

Xianglei He ◽

...

Keyword(s):

Survival Data ◽

Median Overall Survival ◽

Tumor Tissue ◽

Eastern China ◽

Proportional Hazard ◽

Poor Survival ◽

Proportional Hazard Models ◽

Cox Proportional Hazard ◽

Kaplan Meier ◽

Cox Proportional Hazard Models

AbstractFibulin-3 is an extracellular matrix glycoprotein widely expressed in various tissues. Tissue fibulin-3 expression have never been reported in association with prognosis of mesothelioma. Hence, we sought to determine the association between fibulin-3 expression and mesothelioma survival. We made a tissue microarray, which was comprised of cancer and normal tissue from mesothelioma patients (n = 82) during the period 1998–2017 in China. Fibulin-3 and HGMB1 expression were analyzed by immunohistochemistry method. Kaplan–Meier method and Cox proportional hazard models were used for analyzing survival data. Overall, 61 cases (74.4%) were female; 90.2% were of epithelioid type; the median overall survival time was 12.5 months. Fibulin-3 and HMGB1 were highly expressed in tumor tissue rather than adjacent tissue. The expression of fibulin-3 in tissue was correlated with that of HMGB1 (r = 0.32, P = 0.003). High expression of fibulin-3 in tumor tissue could predict poor survival in patients with mesothelioma (P = 0.02). This remained true in a multivariate model, with a significant hazard ratio of 1.91. We demonstrated that fibulin-3 in tumor tissue was a novel biomarker of poor survival of mesothelioma, suggesting it may be a relevant target for therapeutic intervention.

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Dipeptidyl Peptidase-4 Inhibitor Administration Is Associated with Higher Eosinophil Counts and Batter Clinical Outcomes in Patients with Aorta Intramural Hematoma

10.21203/rs.3.rs-1009971/v1 ◽

2021 ◽

Author(s):

qu chen ◽

Dandan Jiang ◽

zhonggui shan

Keyword(s):

Adverse Events ◽

Intramural Hematoma ◽

Proportional Hazard ◽

Oral Antidiabetic Drugs ◽

Dipeptidyl Peptidase 4 ◽

Cox Proportional Hazard ◽

Oral Antidiabetic ◽

Kaplan Meier ◽

Cox Proportional Hazard Models ◽

Related Mortality

Abstract Objectives Investigating whether dipeptidyl peptidase-4 (DPP-4) inhibitors could influence clinical outcomes in intramural hematoma (IMH) patients with diabetes mellitus (DM). Methods IMH patients who received a "wait and watch strategy" were included. Cox proportional hazard models were constructed to identify potential risk factors. A Kaplan–Meier survival analysis was used to estimate all-cause and aorta-related mortality during the follow-up period. Results From January 2000 to December 2020, 1094 IMH patients were divided into group A (n=572, IMH patients without DM), group B (n=191, IMH patients with DM and receiving oral antidiabetic drugs [without admission of DDP-4 inhibitors]) and group C (n=331, IMH patients with DM and receiving oral antidiabetic drugs [including admission of DDP-4 inhibitors]). Group C had the lowest rate of aorta-related adverse events (6.4%), aorta-related mortality (1.2%) and reintervention (5.2%). Cox proportional hazard models revealed that lower eosinophil count (per 0.1, hazard ratio [HR], 0.61; 95% confidence interval [CI], 0.51-0.73, P< 0.001) and thicker hematoma thickness (HR, 1.22; 95% CI, 1.06-1.39, P <0.001) were associated with higher occurrences of aorta-related adverse events. Lower eosinophil count (per 0.1, HR, 0.24; 95% CI, 0.15-0.40, P <0.001), larger descending aorta diameters (HR, 1.12; 95% CI, 1.02-1.23, P <0.021), and thicker hematoma thickness (HR, 3.25; 95% CI, 2.36-4.46, P <0.001) were also associated with increased aorta-related mortality. Kaplan-Meier survival analysis revealed a significant decrease in all-cause and aorta-related mortality in group C ( P <0.001). Conclusions DPP-4 administration influences progression of IMH patients with DM, leading to a lower rate of aorta-related adverse events, aorta-related mortality, and reinterventions.

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Supratentorial hemispheric ependymomas: an analysis of 109 adults for survival and prognostic factors

Journal of Neurosurgery ◽

10.3171/2015.7.jns151187 ◽

2016 ◽

Vol 125 (2) ◽

pp. 410-418 ◽

Cited By ~ 8

Author(s):

Todd Hollon ◽

Vincent Nguyen ◽

Brandon W. Smith ◽

Spencer Lewis ◽

Larry Junck ◽

...

Keyword(s):

Prognostic Factors ◽

Survival Rates ◽

Tumor Grade ◽

Proportional Hazard ◽

Who Grade ◽

Cox Proportional Hazard ◽

Kaplan Meier ◽

Cox Proportional Hazard Models ◽

Who Grade Iii ◽

Grade Iii

OBJECTIVE Survival rates and prognostic factors for supratentorial hemispheric ependymomas have not been determined. The authors therefore designed a retrospective study to determine progression-free survival (PFS), overall survival (OS), and prognostic factors for hemispheric ependymomas. METHODS The study population consisted of 8 patients from our institution and 101 patients from the literature with disaggregated survival information (n = 109). Patient age, sex, tumor side, tumor location, extent of resection (EOR), tumor grade, postoperative chemotherapy, radiation, time to recurrence, and survival were recorded. Kaplan-Meier survival analyses and Cox proportional hazard models were completed to determine survival rates and prognostic factors. RESULTS Anaplastic histology/WHO Grade III tumors were identified in 62% of cases and correlated with older age. Three-, 5-, and 10-year PFS rates were 57%, 51%, and 42%, respectively. Three-, 5-, and 10-year OS rates were 77%, 71%, and 58%, respectively. EOR and tumor grade were identified on both Kaplan-Meier log-rank testing and univariate Cox proportional hazard models as prognostic for PFS and OS. Both EOR and tumor grade remained prognostic on multivariate analysis. Subtotal resection (STR) predicted a worse PFS (hazard ratio [HR] 4.764, p = 0.001) and OS (HR 4.216, p = 0.008). Subgroup survival analysis of patients with STR demonstrated a 5- and 10-year OS of 28% and 0%, respectively. WHO Grade III tumors also had worse PFS (HR 10.2, p = 0.004) and OS (HR 9.1, p = 0.035). Patients with WHO Grade III tumors demonstrated 5- and 10-year OS of 61% and 46%, respectively. Postoperative radiation was not prognostic for PFS or OS. CONCLUSIONS A high incidence of anaplastic histology was found in hemispheric ependymomas and was associated with older age. EOR and tumor grade were prognostic factors for PFS and OS on multivariate analysis. STR or WHO Grade III pathology, or both, predicted worse overall prognosis in patients with hemispheric ependymoma.

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