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conferenceseries.com
Volume 9, Issue 11 (Suppl) J Cancer Sci Ther
ISSN: 1948-5956 JCST, an open access journal Asia Pacific Oncologists 2017
November 20-22, 2017
November 20-22, 2017 Melbourne, Australia
14th Asia Pacific
Oncologists Annual Meeting
A systematic review of intramedullary spinal cord ependymoma and astrocytoma
Kirsty Hamilton1, Benjamin Jonker2 and Sharon Lee1
1Sir Charles Gairdner Hospital, Australia
2RPA-Institute of Academic Surgery, Australia
The true impact of surgical resection and adjuvant therapies on survival in intramedullary ependymoma and astrocytoma
is largely unknown. Searching of Medline, Embase and Clinicaltrials.gov databases were performed. Multivariate
analyses were performed for overall survival (OS) and progression-free survival (PFS) data sets. This was achieved through a
combination of Monte-Carlo methods and maximum likelihood estimation. 57 articles yielded results for 3022 patients. Gross-
total resection (GTR) reduces mortality in both ependymoma and astrocytoma by a factor of 5.1. An interaction was identified
between tumor grade and radiotherapy, such that for low-grade tumors, radiation treatment increased the risk of mortality 5.2
times, while for high-grade tumors radiotherapy decreased mortality by a factor of 1.9. High-grade tumors were associated
with a 12 times risk of death over low-grade tumors. Adult patients were more likely to die from their disease compared with
pediatric patients by a factor of 1.6. Regarding PFS, radiation treatment increased the rate of morbidity 1.9 times for both
pathologies. Gender did not influence survival. 79% of patients demonstrated stable or improved functional neurological
outcomes six months post-operatively. GTR improves OS in all tumor grades. Adjuvant radiation improves OS only in the
presence of high-grade histology. Advancing age and high-grade histology are negative prognostic indicators. Gender does not
influence survival.
Biography
Kirsty Hamilton is a Neurosurgical Trainee, currently practicing at the Princess Alexandra Hospital, Brisbane. Her research work deals with intra-medullary spinal
cord tumors, which was undertaken to address a knowledge gap in the literature for intramedullary tumor treatment strategies.
Kirsty Hamilton et al., J Cancer Sci Ther 2017, 9:11 (Suppl)
DOI: 10.4172/1948-5956-C1-117