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60

NCCN Guidelines for Patients

®

:

Brain Cancer – Gliomas, Version 1.2016

Diagnosis and treatment

More research on the treatment of ependymoma

is needed. At this time, surgery is very important

for diagnosis and treatment. Tissue needs to be

removed to confirm the diagnosis and for cancer

grading.

Guide 18

lists treatment options for ependymoma.

Your surgeon will assess how much of the tumor he

or she can remove. The amount that will be removed

depends on where the tumor is, your age and health,

and other factors. Your surgeon does not want you to

be less able to think, speak, and move afterward.

Maximal safe resection

A maximal safe resection is a treatment plan to

remove all or most of the tumor as is safe. Hopefully,

the whole tumor will be removed. Removal of the

whole tumor is called a gross total resection.

Your surgeon may decide during surgery that the

whole tumor can’t be removed. Removing only part

of the tumor is called a subtotal resection. Your

surgeon may advise a second surgery to try to

remove the whole tumor.

Other surgeries

There are other options if it is known before surgery

that a maximal safe resection can’t be done. These

options are a subtotal resection, open biopsy, and

stereotactic biopsy. Your surgeon may advise a

second surgery to try to remove the whole tumor.

Tests after surgery

The removed tissue will be sent to a pathologist for

testing. The pathologist will confirm if there’s cancer,

and if so, the cancer grade.

You should receive brain and spine MRIs after

surgery. If you can’t have MRI, you may receive

CT scans. Images will be made with and without

contrast.

The brain MRI should be done within 24 to 72 hours

after surgery. The images will show how much of the

brain tumor was removed. If you had a spinal tumor,

a brain MRI will be used to assess if there’s cancer in

the brain, too.

The spine MRI should be done 2 to 3 weeks after

surgery. Images will be less affected by surgery by

then. Images will show how much of the spinal tumor

5

Ependymomas

Diagnosis and treatment

Guide 18. Surgery

Your surgery status

What are the options?

Approved and agree to removing most of the tumor

ª

• Maximal safe resection

Approved and agree to removing some of the tumor

ª

• Stereotactic biopsy

ª

• Open biopsy

ª

• Subtotal resection