Long-term follow-up in 39 patients with an ependymoma after surgery and irradiation.

1954 to 1989, 33 patients with intracranial ependymomas had primary treatment in our hospital with surgery and postoperative radiotherapy. Five- and ten-year survival rates were 48% and 34% in 25 patients with a high-grade ependymoma and for low-grade ependymomas was maintained at 78% for both the five- and ten-year follow-up period. Cumulative frequency of local or intracranial recurrence was 70% (high-grade) and 20% (low-grade). Despite the fact, that only three of 25 patients with high-grade ependymomas had spinal irradiation with 19.5 to 30 Gy, there was only a single patient with clinical signs of spinal metastases simultaneously with an intracranial recurrence. Twelve out of 13 living patients without signs of tumor have been classified according to the neurological performance: Performance was good or very good in five patients, satisfying in three with an independent life, fair in two patients working in a sheltered office and dependent on some assistance and poor in two patients. Published results are discussed and compared with the own observations and our current treatment policy is given.