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Child's Nervous System

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01-05-2006 | Original Paper

A review of clinical and histological features of Spanish paediatric medulloblastomas during the last 21 years

Authors: Alejandro Urberuaga, Aurora Navajas, Juan Burgos, José Ignacio Pijoán

Published in: Child's Nervous System | Issue 5/2006

Abstract

Purpose

To find any feature of prognostic significance among the clinical and histological characteristics of paediatric patients diagnosed with medulloblastoma (MB).

Materials and methods

Clinical charts and paraffin blocks of 79 paediatric patients from nine Spanish institutions diagnosed with MB between 1980 and 2001 were reviewed retrospectively. Included clinical and histological characteristics were age, sex, duration of symptoms, physical signs on admission, tumour location, T and M stages of Chang classification, hydrocephalus, cerebrospinal fluid shunt, surgical resection, complications after surgery, MB subtype, desmoplasia, nodularity, fibrilar pattern, nuclear pleomorphism, necrosis grade, proliferation index and intra-tumoural vascularity. Overall and event-free survival (EFS) univariate and multivariate analyses were assessed.

Results

Type of surgery and necrosis grade appeared to be independent prognostic variables in overall and EFSs. Although nuclear pleomorphism and intra-tumoural vascularity showed a marginally statistical effect on overall survival (OS), both had a significant influence on EFS.

Conclusion

We have confirmed surgical resection and added necrosis grade as independent prognostic factors in terms of OS for children diagnosed with MB.

Peris-Bonet R, Giner B, García A et al (2003) Registro Nacional de Tumores Infantiles. Estadísticas básicas 4. 1980–2001, Supervivencia 1980–1997. Universitat de València, Valencia

Muñoz A (1997) Introducción a la oncología pediátrica. In: Madero L, Muñoz A (eds) Hematología y oncología pediátricas. Ergon, Madrid, pp 197–206

Strother DR, Pollack IF, Fisher PG et al (2002) Tumors of the central nervous system. In: Pizzo PA, Poplack DG (eds) Principles and practice of pediatric oncology, 4th edn. Lippincott, Philadelphia, pp 751–824

Taylor RE, Bailey CC, Robinson K et al (2003) Results of a randomized study of preradiation chemotherapy versus radiotherapy alone for nonmetastatic medulloblastoma: The International Society of Paediatric Oncology/United Kingdom Children's Cancer Study Group PNET-3 Study. J Clin Oncol 21:1581–1591PubMedCrossRef

Packer RJ, Goldwein J, Nicholson HS et al (1999) Treatment of children with medulloblastoma with reduced-dose craniospinal radiation therapy and adjuvant chemotherapy: a Children's Cancer Group Study. J Clin Oncol 17:2127–2136PubMed

Freeman CR, Taylor RE, Kortmann RD, Carrie C (2002) Radiotherapy for medulloblastoma in children: a perspective on current international clinical research efforts. Med Pediatr Oncol 39:99–108PubMedCrossRef

Zeltzer PM, Boyett JM, Finlay JL et al (1999) Metastasis stage, adjuvant treatment, and residual tumor are prognostic factors for medulloblastoma in children: conclusions from the Children's Cancer Group 921 randomized phase III study. J Clin Oncol 17:832–845PubMed

Yock TI, Friedman H, Kun L, Kepner J, Barnes P, Tarbell NJ (2001) Response to pre-radiation chemotherapy is predictive of improved survival in high-risk medulloblastoma: results from Pediatric Oncology Group (POG 9031). Int J Radiat Oncol Biol Phys 51 (3 Suppl 1):S120–S121

Dennis M, Spiegler BJ, Hetherington CR, Greenberg ML (1996) Neuropsychological sequelae of the treatment of children with medulloblastoma. J Neurooncol 29:91–101PubMedCrossRef

10.

Walter AW, Mulhern RK, Gajjar A et al (1999) Survival and neurodevelopmental outcome of young children with medulloblastoma at St. Jude Children's Research Hospital. J Clin Oncol 17:3720–3728PubMed

11.

Duffner PK, Cohen ME, Anderson SW et al (1983) Long-term effects of treatment on endocrine function in children with brain tumors. Ann Neurol 14:528–532PubMedCrossRef

12.

Schell MJ, McHaney VA, Green AA et al (1989) Hearing loss in children and young adults receiving cisplatin with or without prior cranial irradiation. J Clin Oncol 7:754–760PubMed

13.

Stavrou T, Bromley CM, Nicholson HS et al (2001) Prognostic factors and secondary malignancies in childhood medulloblastoma. J Pediatr Hematol Oncol 23:431–436PubMedCrossRef

14.

Packer RJ, Boyett JM, Janss AJ et al (2001) Growth hormone replacement therapy in children with medulloblastoma: use and effect on tumor control. J Clin Oncol 19:480–487PubMed

15.

Albright AL, Wisoff JH, Zeltzer PM, Boyett JM, Rorke LB, Stanley P (1996) Effects of medulloblastoma resections on outcome in children: a report from the Children's Cancer Group. Neurosurgery 38:265–271PubMedCrossRef

16.

Giangaspero F, Perilongo G, Fondelli MP et al (1999) Medulloblastoma with extensive nodularity: a variant with favorable prognosis. J Neurosurg 91:971–977PubMedCrossRef

17.

Giangaspero F, Rigobello L, Badiali M et al (1992) Large-cell medulloblastomas. A distinct variant with highly aggressive behavior. Am J Surg Pathol 16:687–693PubMedCrossRef

18.

Brown HG, Kepner JL, Perlman EJ et al (2000) “Large cell/anaplastic” medulloblastomas: a Pediatric Oncology Group Study. J Neuropathol Exp Neurol 59:857–865PubMed

19.

Eberhart CG, Kepner JL, Goldthwaite PT et al (2002) Histopathological grading of medulloblastomas: a Pediatric Oncology Group study. Cancer 94:552–560PubMedCrossRef

20.

Chang CH, Housepian EM, Herbert C Jr (1969) An operative staging system and a megavoltage radiotherapeutic technic for cerebellar medulloblastomas. Radiology 93:1351–1359PubMed

21.

WHO (2000) WHO classification of tumours of the nervous system. In: Kleihues P, Cavenee WK (eds) Pathology and genetics of tumours of the nervous system. World Health Organization classification of tumours. IARC, Lyon, pp 6–7

22.

Hosmer DW Jr, Lemeshow S (1999) Applied survival analysis: regression modeling of time to event data. Wiley, New York

23.

Weil MD, Lamborn K, Edwards MS, Wara WM (1998) Influence of a child's sex on medulloblastoma outcome. JAMA 279:1474–1476PubMedCrossRef

24.

Halperin EC, Watson DM, George SL (2000) Duration of symptoms prior to diagnosis is related inversely to presenting disease stage in children with medulloblastoma. Cancer 91:1444–1450CrossRef

25.

Sure U, Berghorn WJ, Bertalanffy H et al (1995) Staging, scoring and grading of medulloblastoma. A postoperative prognosis predicting system based on the cases of a single institute. Acta Neurochir (Wien) 132:59–65CrossRef

26.

Tait DM, Thornton-Jones H, Bloom HJ, Lemerle J, Morris-Jones P (1990) Adjuvant chemotherapy for medulloblastoma: the first multicentre controlled trial of the International Society of Paediatric Oncology (SIOP). Eur J Cancer 26:464–469PubMed

27.

Frost PJ, Laperriere NJ, Wong CS, Milosevic MF, Simpson WJ, Pintilie M (1995) Medulloblastoma in adults. Int J Radiat Oncol Biol Phys 32:951–957PubMed

28.

Grotzer MA, Geoerger B, Janss AJ, Zhao H, Rorke LB, Phillips PC (2001) Prognostic significance of ki-67 (MIB-1) proliferation index in childhood primitive neuroectodermal tumors of the central nervous system. Med Pediatr Oncol 36:268–273PubMedCrossRef

29.

Miralbell R, Tolnay M, Bieri S et al (1999) Pediatric medulloblastoma: prognostic value of p53, bcl-2, Mib-1, and microvessel density. J Neurooncol 45:103–110PubMedCrossRef

30.

Grotzer MA, Wiewrodt R, Janss AJ et al (2001) High microvessel density in primitive neuroectodermal brain tumors of childhood. Neuropediatrics 32:75–79PubMedCrossRef

Title: A review of clinical and histological features of Spanish paediatric medulloblastomas during the last 21 years
Authors: Alejandro Urberuaga
Aurora Navajas
Juan Burgos
José Ignacio Pijoán
Publication date: 01-05-2006
Publisher: Springer-Verlag
Published in: Child's Nervous System / Issue 5/2006
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-005-0004-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

A review of clinical and histological features of Spanish paediatric medulloblastomas during the last 21 years

Abstract

Purpose

Materials and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusion

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