Abstract
Introduction: Surgical resection is a generally accepted standard treatment modality in Gll posterior fossa ependymomas in adults, while the role of adjuvant radiotherapy remains unclear. The purpose of this study was to evaluate local control of tumor growth and clinical outcome of patients after surgical treatment of Gll fourth ventricle ependymomas.
Material and methods: We conducted a retrospective study of 15 adult patients (seven males and eight females) with histologically confirmed Gll fourth ventricular ependymoma between January 2001 and December 2011. Results: Gross total resection was achieved in 12 patients, none of them received adjuvant treatment after the initial surgery.
Median follow-up after GTR was 51 months (min. -max.; 11-123 months). One patient showed radiographic signs of tumor recurrence and was re-operated 51 months after the initial surgery.
Remaining patients were without any signs of tumor recurrence. After the surgery, a new neurological deficit occurred in two patients.
Two of the three patients after subtotal tumor resection showed residual mass progression after 11 and 16 months postoperatively, one of them was re-operated 27 months after the initial surgery. Adjuvant radiotherapy was indicated in both re-operated patients.
Conclusion: According to our data, gross total resection is effective and safe treatment of Gll fourth ventricle ependymomas. Adjuvant radiotherapy should be reserved for the cases where complete removal of tumor mass is not possible and residual tumor is growing, or after repeated resection.