Risk factors for the prognosis of pediatric medulloblastoma: a retrospective analysis of 40 cases
Clinics; 72 (5), 2017
Publication year: 2017
OBJECTIVES:
In this study, we evaluated the association of molecular subtypes, clinical characteristics and pathological types with the prognosis of patients with medulloblastoma.METHODS:
We analyzed forty patients with medulloblastoma who underwent surgical resection at our center between January 2004 and June 2014. Risk factors associated with survival, disease progression and recurrence were analyzed with a univariate Cox regression analysis, and the identified significant risk factors were further analyzed by Kaplan-Meier survival curves.RESULTS:
Factors associated with overall survival included M stage (p=0.014), calcification (p=0.012), postoperative treatment, postoperative Karnofsky Performance Scale (KPS) score (p=0.015), and molecular subtype (p=0.005 for WNT and p=0.008 for SHH). Number of symptoms (p=0.029), M stage (p<0.001), and postoperative radiotherapy (p=0.033) were associated with disease progression. Patients with the WNT or SHH subtype had better survival outcomes than patients with non-WNT/SHH subtypes. Risk factors for disease progression-free survival were symptoms >2 and ≥M1 stage without postoperative radiotherapy. The risk of recurrence increased with advanced M stage. Protective factors for recurrence included M0 stage and a combination of chemotherapy and radiotherapy.CONCLUSION:
We identified the risk factors associated with survival, disease progression and recurrence of medulloblastoma patients. This information is helpful for understanding the prognostic factors related to medulloblastoma.
Neoplasias Cerebelosas, Neoplasias Cerebelosas/mortalidad, Neoplasias Cerebelosas/patología, Neoplasias Cerebelosas/terapia, Quimioterapia Adyuvante, Terapia Combinada, Progresión de la Enfermedad, Inmunohistoquímica, Estimación de Kaplan-Meier, Estado de Ejecución de Karnofsky, Meduloblastoma, Meduloblastoma/mortalidad, Meduloblastoma/patología, Meduloblastoma/terapia, Recurrencia Local de Neoplasia, Periodo Posoperatorio, Pronóstico, Estudios Retrospectivos, Medición de Riesgo, Factores de Riesgo, Factores de Tiempo