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@ARTICLE{Ramaswamy:130384,
      author       = {V. Ramaswamy and T. Hielscher$^*$ and S. C. Mack and A.
                      Lassaletta and T. Lin and K. Pajtler$^*$ and D. Jones$^*$
                      and B. Luu and F. M. G. Cavalli and K. Aldape and M. Remke
                      and M. Mynarek and S. Rutkowski and S. Gururangan and R. E.
                      McLendon and E. S. Lipp and C. Dunham and J. Hukin and D. D.
                      Eisenstat and D. Fulton and F. K. H. van Landeghem and M.
                      Santi and M. C. van Veelen and E. G. Van Meir and S. Osuka
                      and X. Fan and K. M. Muraszko and D. P. C. Tirapelli and S.
                      M. Oba-Shinjo and S. K. N. Marie and C. G. Carlotti and J.
                      Y. Lee and A. A. N. Rao and C. Giannini and C. C. Faria and
                      S. Nunes and J. Mora and R. L. Hamilton and P. Hauser and N.
                      Jabado and K. Petrecca and S. Jung and L. Massimi and M.
                      Zollo and G. Cinalli and L. Bognár and A. Klekner and T.
                      Hortobágyi and S. Leary and R. P. Ermoian and J. M. Olson
                      and J. R. Leonard and C. Gardner and W. A. Grajkowska and L.
                      B. Chambless and J. Cain and C. G. Eberhart and S. Ahsan and
                      M. Massimino and F. Giangaspero and F. R. Buttarelli and R.
                      J. Packer and L. Emery and W. H. Yong and H. Soto and L. M.
                      Liau and R. Everson and A. Grossbach and T. Shalaby and M.
                      Grotzer and M. A. Karajannis and D. Zagzag and H. Wheeler
                      and K. von Hoff and M. M. Alonso and T. Tuñon and U.
                      Schüller and K. Zitterbart and J. Sterba and J. A. Chan and
                      M. Guzman and S. K. Elbabaa and H. Colman and G. Dhall and
                      P. G. Fisher and M. Fouladi and A. Gajjar and S. Goldman and
                      E. Hwang and M. Kool$^*$ and H. Ladha and E. Vera-Bolanos
                      and K. Wani and F. Lieberman and T. Mikkelsen and A. M.
                      Omuro and I. F. Pollack and M. Prados and H. I. Robins and
                      R. Soffietti and J. Wu and P. Metellus and U. Tabori and U.
                      Bartels and E. Bouffet and C. E. Hawkins and J. T. Rutka and
                      P. Dirks and S. Pfister$^*$ and T. E. Merchant and M. R.
                      Gilbert and T. S. Armstrong and A. Korshunov$^*$ and D. W.
                      Ellison and M. D. Taylor},
      title        = {{T}herapeutic {I}mpact of {C}ytoreductive {S}urgery and
                      {I}rradiation of {P}osterior {F}ossa {E}pendymoma in the
                      {M}olecular {E}ra: {A} {R}etrospective {M}ulticohort
                      {A}nalysis.},
      journal      = {Journal of clinical oncology},
      volume       = {34},
      number       = {21},
      issn         = {1527-7755},
      address      = {Alexandria, Va.},
      publisher    = {American Society of Clinical Oncology},
      reportid     = {DKFZ-2017-05463},
      pages        = {2468 - 2477},
      year         = {2016},
      abstract     = {Posterior 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.},
      cin          = {C060 / G380 / B062},
      ddc          = {050},
      cid          = {I:(DE-He78)C060-20160331 / I:(DE-He78)G380-20160331 /
                      I:(DE-He78)B062-20160331},
      pnm          = {319H - Addenda (POF3-319H)},
      pid          = {G:(DE-HGF)POF3-319H},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:27269943},
      pmc          = {pmc:PMC4962737},
      doi          = {10.1200/JCO.2015.65.7825},
      url          = {https://inrepo02.dkfz.de/record/130384},
}