Telomerase reverse transcriptase gene promoter (TERTp) mutation has been identified in a subset of ependymomas with aggressive behavior ¹⁾.

Despite its benign biological nature, myxopapillary ependymoma (MPE) has a propensity to recur locally or distantly. Although variables influencing the prognosis, such as age, the extent of resection and radiotherapy, have been widely discussed, no definitive standard has been established.

Compared to other spinal tumors, many fewer histological markers have been elucidated to assist the determination of the prognosis.

Treatment failure of MPE occurred in approximately one-third of patients. The observed recurrence pattern of primary spinal MPE was mainly local, but a substantial number of patients failed nonlocally. Younger patients and those not treated initially with adjuvant RT or not undergoing gross total resection were significantly more likely to present with tumor recurrence/progression ²⁾.

The 5-year survival rate of spinal ependymomas ranges from 57–100% ^3) 4) 5) and 10–33% of patients will experience local invasion of the tumour or recurrence ^6) 7).

Metastasis is rare in MPE but there have been several reported cases ^{8) 9) 10) 11) 12) 13) 14) 15) 16) 17) 18) 19) 20)}.