Therapeutic Impact of Cytoreductive Surgery and Irradiation of Posterior Fossa Ependymoma in the Molecular Era: A Retrospective Multicohort Analysis
Why is this work in the frame?
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
No Canadian affiliation. An affiliation-only frame, the usual design, would never have seen this work. It is one of the works that make the case for inverting the frame.
Full frame distilled prediction
Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
- Candidate categories
- none
- Consensus categories
- none
- Domain
- Candidate signal: noneConsensus signal: none
- Study design
- Candidate signal: ObservationalConsensus signal: Observational
- Genre
- Candidate signal: EmpiricalConsensus signal: Empirical
- Teacher disagreement score
- 0.048
- Threshold uncertainty score
- 0.226
- Validation status
machine_predicted_unvalidated·codex-gemma-dda1882f352a
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
- Teacher spread
- 0.381 · how far apart the two teachers sit on this one work
- Validation status
score_only:v0-immature-baseline· verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it
Abstract
PURPOSE: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
The record
- Venue
- Journal of Clinical Oncology
- Topic
- Glioma Diagnosis and Treatment
- Field
- Medicine
- Canadian institutions
- not available
- Funders
- National Center for Advancing Translational SciencesNational Institute of Neurological Disorders and StrokeCanadian Institutes of Health ResearchCollege of Medicine, Seoul National UniversityUniversity of North Carolina at Chapel HillRally FoundationMedical Center, University of PittsburghChonnam National University Hwasun HospitalUniversity of Texas MD Anderson Cancer CenterNational Institutes of HealthLékařská fakulta, Masarykova univerzitaPfizerUniversity of WashingtonUniversity of California, Los AngelesMasarykova UniverzitaHospital for Sick ChildrenMagyar Tudományos AkadémiaErasmus Universitair Medisch Centrum RotterdamGenentechDebreceni EgyetemChonnam National UniversitySemmelweis EgyetemMedical School, University of MichiganUniversity of CincinnatiUniversity of SydneyMaking Headway FoundationSapienza Università di RomaEmory UniversityHuntsman Cancer InstituteChildren's National HospitalMemorial Sloan-Kettering Cancer CenterJohns Hopkins UniversityUniversità degli Studi di TorinoCincinnati Children's Hospital Medical CenterAlberta InnovatesUniversidade de São PauloChildren's Hospital of PhiladelphiaNYU Langone Medical CenterCURE Childhood CancerUniversity of PittsburghAlex's Lemonade Stand Foundation for Childhood CancerChildren's Hospital Los AngelesNational Cancer InstituteSt. Baldrick's FoundationHudson Institute of Medical ResearchYork UniversityUniversità degli Studi di Napoli Federico IIPediatric Brain Tumor FoundationVanderbilt UniversitySeattle Children's Research InstituteUniversity of PennsylvaniaDeutsche KinderkrebsstiftungCERNUniversity of TorontoSeoul National University
- Keywords
- EpendymomaMedicineRadiation therapySurgeryProportional hazards modelRegimenAdjuvant therapyOncologyInternal medicineChemotherapy
- Has abstract in OpenAlex
- yes