Xi S, et al. - Researchers focused in ependymal tumors regarding the importance of histological features, the v-relavian reticuloendotheliosis viral oncogene homolog A (RELA) fusions, and other molecular characteristics. They found a tight correlation of hypercellularity, atypia, microvascular proliferation, necrosis, mitosis, and an elevated Ki-67 index with an advanced tumor grade. A connection of tumor location, necrosis, mitosis and the Ki-67 index with the survival of the ependymomas was identified, but the only independent prognostic factor was Ki67. Pediatric grade III intracranial ependymomas, mostly exhibited RELA fusions, were found to be suggestive of lower survival times of patients and had a close association with patients’ age, tumor grade, cellularity, cellular atypia, necrosis, and Ki67 index in the intracranial ependymal tumors. In ependymal tumors, a worse prognosis was predicted by attenuation of trimethylation of histone 3 lysine 27 (H3K27me3). Among Chinese patients with ependymal tumors, tumor grading and prognostic predictions were facilitated by histological and molecular characteristics.