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000130384 1001_ $$aRamaswamy, Vijay$$b0
000130384 245__ $$aTherapeutic Impact of Cytoreductive Surgery and Irradiation of Posterior Fossa Ependymoma in the Molecular Era: A Retrospective Multicohort Analysis.
000130384 260__ $$aAlexandria, Va.$$bAmerican Society of Clinical Oncology$$c2016
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000130384 520__ $$aPosterior fossa ependymoma comprises two distinct molecular variants termed EPN_PFA and EPN_PFB that have a distinct biology and natural history. The therapeutic value of cytoreductive surgery and radiation therapy for posterior fossa ependymoma after accounting for molecular subgroup is not known.Four independent nonoverlapping retrospective cohorts of posterior fossa ependymomas (n = 820) were profiled using genome-wide methylation arrays. Risk stratification models were designed based on known clinical and newly described molecular biomarkers identified by multivariable Cox proportional hazards analyses.Molecular subgroup is a powerful independent predictor of outcome even when accounting for age or treatment regimen. Incompletely resected EPN_PFA ependymomas have a dismal prognosis, with a 5-year progression-free survival ranging from 26.1% to 56.8% across all four cohorts. Although first-line (adjuvant) radiation is clearly beneficial for completely resected EPN_PFA, a substantial proportion of patients with EPN_PFB can be cured with surgery alone, and patients with relapsed EPN_PFB can often be treated successfully with delayed external-beam irradiation.The most impactful biomarker for posterior fossa ependymoma is molecular subgroup affiliation, independent of other demographic or treatment variables. However, both EPN_PFA and EPN_PFB still benefit from increased extent of resection, with the survival rates being particularly poor for subtotally resected EPN_PFA, even with adjuvant radiation therapy. Patients with EPN_PFB who undergo gross total resection are at lower risk for relapse and should be considered for inclusion in a randomized clinical trial of observation alone with radiation reserved for those who experience recurrence.
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000130384 7001_ $$aMack, Stephen C$$b2
000130384 7001_ $$aLassaletta, Alvaro$$b3
000130384 7001_ $$aLin, Tong$$b4
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000130384 7001_ $$aLuu, Betty$$b7
000130384 7001_ $$aCavalli, Florence M G$$b8
000130384 7001_ $$aAldape, Kenneth$$b9
000130384 7001_ $$aRemke, Marc$$b10
000130384 7001_ $$aMynarek, Martin$$b11
000130384 7001_ $$aRutkowski, Stefan$$b12
000130384 7001_ $$aGururangan, Sridharan$$b13
000130384 7001_ $$aMcLendon, Roger E$$b14
000130384 7001_ $$aLipp, Eric S$$b15
000130384 7001_ $$aDunham, Christopher$$b16
000130384 7001_ $$aHukin, Juliette$$b17
000130384 7001_ $$aEisenstat, David D$$b18
000130384 7001_ $$aFulton, Dorcas$$b19
000130384 7001_ $$avan Landeghem, Frank K H$$b20
000130384 7001_ $$aSanti, Mariarita$$b21
000130384 7001_ $$avan Veelen, Marie-Lise C$$b22
000130384 7001_ $$aVan Meir, Erwin G$$b23
000130384 7001_ $$aOsuka, Satoru$$b24
000130384 7001_ $$aFan, Xing$$b25
000130384 7001_ $$aMuraszko, Karin M$$b26
000130384 7001_ $$aTirapelli, Daniela P C$$b27
000130384 7001_ $$aOba-Shinjo, Sueli M$$b28
000130384 7001_ $$aMarie, Suely K N$$b29
000130384 7001_ $$aCarlotti, Carlos G$$b30
000130384 7001_ $$aLee, Ji Yeoun$$b31
000130384 7001_ $$aRao, Amulya A Nageswara$$b32
000130384 7001_ $$aGiannini, Caterina$$b33
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000130384 7001_ $$aNunes, Sofia$$b35
000130384 7001_ $$aMora, Jaume$$b36
000130384 7001_ $$aHamilton, Ronald L$$b37
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000130384 7001_ $$aChambless, Lola B$$b54
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000130384 7001_ $$aEberhart, Charles G$$b56
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000130384 7001_ $$aButtarelli, Francesca R$$b60
000130384 7001_ $$aPacker, Roger J$$b61
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000130384 7001_ $$aYong, William H$$b63
000130384 7001_ $$aSoto, Horacio$$b64
000130384 7001_ $$aLiau, Linda M$$b65
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