Neoadjuvant chemotherapy versus upfront resection in ampullary adenocarcinoma stratified by stage: A retrospective analysis using the National Cancer Database.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 318-318
Author(s):  
Shravan Leonard-Murali ◽  
Rupen A. Shah ◽  
Tommy Ivanics ◽  
Xiaoxia Han ◽  
Christopher P. Steffes ◽  
...  
Keyword(s):  
Overall Survival ◽  
Radical Surgery ◽  
Standard Of Care ◽  
Ampullary Carcinoma ◽  
Proportional Hazard ◽  
Ampullary Adenocarcinoma ◽  
Cox Proportional Hazard ◽  
Kaplan Meier ◽  
Positive Nodal Status ◽  
Cox Proportional Hazard Models

318 Background: Outcomes of a neoadjuvant therapy (NAT) strategy to treat ampullary adenocarcinoma (AAC) are unclear. Upfront resection (UR) (typically pancreaticoduodenectomy) with or without adjuvant therapy (AT) is currently the standard of care. We looked to assess outcomes of NAT followed by radical surgery for AAC. Methods: The NCDB was queried for ampullary carcinoma patients from 2004-2015. Patients with Stage I to III AAC who underwent radical surgery were included, and separated into NAT with surgery and UR groups. Demographic/clinical/pathologic data and their associations to survival were analyzed with univariate and multivariate cox proportional hazard models. Overall survival was estimated from time of diagnosis using Kaplan-Meier curves and compared using log-rank tests (LRT) (see table). Statistical analyses were performed using R version 3.5.1 with significance established at p < 0.05. Results: There was no difference in overall survival between the NAT (n = 47) and UR (n = 1521) groups, either as total groups (LRT p = 0.2), or when stratified by stage (stratified LRT p = 0.5). Rates of AT were higher in the UR group (p = 0.038). Receiving AT was significantly associated with improved survival (hazard ratio (HR) = 0.648), while positive nodal status (HR = 2.06), stage 3 disease (HR = 1.542), age > 65 (HR = 1.494), and male gender (HR = 1.241) were significantly associated with decreased overall survival by multivariate analysis. Conclusions: NAT does not offer a survival advantage over UR either overall or for stage-specific disease. This finding extended even to stage III disease, where NAT would theoretically offer greatest benefit. This study suggests that a NAT strategy is not preferable to UR for treatment of resectable AAC, regardless of stage. Higher powered study of NAT for AAC with controls for AT is warranted before discarding a NAT strategy. [Table: see text]

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

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.

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

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.

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

Circulation ◽  
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.

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

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Hanumantha R Jogu ◽  
Parag A Chevli ◽  
Geeth Sandeep Nadella ◽  
Tareq S Islam ◽  
Abhishek Dutta ◽  
...  
Keyword(s):  
Myocardial Injury ◽  
Final Analysis ◽  
Antiplatelet Agents ◽  
Noncardiac Surgery ◽  
Proportional Hazard ◽  
Cox Proportional Hazard ◽  
Cardiac Procedures ◽  
Kaplan Meier ◽  
Cox Proportional Hazard Models ◽  
Poor Outcomes

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.

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

Stroke ◽  
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.

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

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]

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

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.

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

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.

scholarly journals Prognostic Significance of Cytoplasmic SPNS2 Expression in Patients with Oral Squamous Cell Carcinoma

Medicina ◽  
2021 ◽  
Vol 57 (2) ◽  
pp. 164
Author(s):  
Jeng-Wei Lu ◽  
Yen-Shuo Tseng ◽  
Yu-Sheng Lo ◽  
Yueh-Min Lin ◽  
Chung-Min Yeh ◽  
...  
Keyword(s):  
Overall Survival ◽  
Squamous Cell Carcinoma ◽  
Protein Expression ◽  
Hazard Models ◽  
Proportional Hazard ◽  
Cytoplasmic Protein ◽  
Proportional Hazard Models ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Models ◽  
Tissue Specimens

Background and Objectives: Oral squamous cell carcinoma (OSCC) is a malignant disease with a particularly high incidence in Taiwan. Our objective in this study was to elucidate the involvement of sphingolipid transporter 2 (SPNS2) expression and SPNS2 protein expression in the clinicopathological indexes and the clinical outcomes of OSCC patients. Materials and Methods: Immunohistochemistry analysis was performed for SPNS2 protein expression in samples from 264 cases of OSCC. Correlations of SPNS2 expression with clinicopathological variables and patient survival were analyzed. Results: Our results revealed that the cytoplasmic protein expression of SPNS2 in OSCC tissue specimens was lower than in normal tissue specimens. Negative cytoplasmic protein expression of SPNS2 was significantly correlated with T status and stage. Kaplan–Meier survival curve analysis revealed that negative cytoplasmic SPNS2 expression was predictive of poorer overall survival of OSCC patients in stage III/IV. We also determined that low SPNS2 expression was an independent prognostic factor related to overall survival among OSCC patients in stage III/IV from univariate Cox proportional hazard models. Multivariate Cox proportional hazard models revealed that cytoplasmic SPNS2 expression, T status, lymph node metastasis, and histological grade were independent prognostic factors for survival. Conclusions: Overall, this study determined that SPNS2 protein may be a useful prognostic marker for OSCC patients and potential therapeutic target for OSCC treatment.

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

2016 ◽  
Vol 125 (2) ◽  
pp. 410-418 ◽  
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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