Ho et al developed criteria for classifying an ependymoma as anaplastic. This correlates with survival. The authors are from the Veterans General Hospital in Taipei, Taiwan.
Parameters:
(1) mitotic rate in 10 consecutive high power fields
(2) hypercellularity
(3) proliferation of endothelium
(4) tumor necrosis
|
Parameter |
Finding |
Points |
|
mitotic rate |
< 4 per 10 high power fields |
0 |
|
|
>= 4 per 10 high power fields |
1 |
|
hypercellularity |
absent |
0 |
|
|
present |
1 |
|
endothelial proliferation |
absent |
0 |
|
|
present |
1 |
|
tumor necrosis |
absent |
0 |
|
|
present |
1 |
where:
• The microscopic field area using the high power lens is given as 0.24 square mm. 10 hpf would be an area of 2.4 square mm. A mitotic rate of 4 in 10 high power fields correlates to 1.67 mitoses per square mm.
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 4
• A score >= 2 indicates an anaplastic ependymoma.
• A score >= 2 and subtotal resection was associated with increased risk of recurrence.
|
Score |
10 Year Survival |
|
0 or 1 |
90% |
|
2 - 4 |
56% |
Specialty: Hematology Oncology, Surgery, general, Neurology
