Objective: In the present study we aimed to assess the prognostic value of age, tumor localization, extent of surgery, histological grade, p53 protein and Ki67 proliferation index in pediatric cases diagnosed as ependymoma.

Material and Method: Twenty-eight pediatric ependymoma cases diagnosed from 1997 to 2007 in our department were included in the study. The relation between age, tumor localization, extent of surgery, histological grade, Ki67 proliferative index, p53 tumor supressor protein, and survival for the 23 cases with follow up data were evaluated.

Results: Histologically, 14 of the tumors were anaplastic and 14 classical ependymoma. 13 of the 16 cases with Ki67 equal or lower than 10% and one of the 12 cases with Ki67 more than 10% were grade 2 ependymoma. A significant relation was found between Ki67 and histological grade. p53 protein was positive in 10 cases, negative in 18. Seventy percent of the mutant p53 immunreactive cases were grade 3 ependymomas. No significant relation was found between p53 expression and histological grade.

Of the 23 cases with follow up, the mean survival was 16 months for six patients younger than three years and 83,7 months for 17 patients older than three years. A significant relation was found between age and survival.

No significant relation was found between histological grade, expressions of p53, and Ki67, and tumor localization, extent of surgery and survival.

Conclusion: In the present study, a significant relation was found between histological grade and Ki67 proliferation index. Age was the only prognostic factor shown to have prognostic significance in cases of pediatric ependymoma.