An analysis of medulloblastoma: 10 year experience of a referral institution in South India

Gaur, Smriti; Kumar, SS; Balasubramaniam, P.

doi:10.4103/0019-509x.178404

Cited by 12 publications

(7 citation statements)

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“…Clinical characteristics were comparable with previous studies. [ 14 15 ] Nevertheless, the severity of disease, in our study, tended to be more aggressive. More than half of the patients had metastatic disease compared with previous studies.…”

Section: Discussioncontrasting

confidence: 43%

Survival and prognostic factors in pediatric patients with medulloblastoma in southern Thailand

et al. 2018

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Background:The current prognosis of medulloblastoma in children is better because of technological advancements and improvements in treatment strategies and genetic investigations. However, there is a lack of studies that focus on medulloblastoma in Thailand. The aims of our study were to conduct a survival analysis and to identify the prognostic factors of pediatric medulloblastoma.Materials and Methods:Fifty-five children, with medulloblastoma, were eligible for analysis between 1991 and 2015. We retrospectively reviewed both the clinical and the histological data. Survival curves were constructed using the Kaplan–Meier method. For comparisons of dichotomous factors, between groups, the log-rank test was used to determine survival. The Cox proportional hazard regression model was used to identify the univariate and multivariate survival predictors.Results:The mortality rate was 49.1% in this study. The median follow-up time was 68.8 months (range: 1–294 months). The 5-year overall survival rate and median survival time were 53.8% (95% CI 38.7–66.7) and 80 months (95% CI 23–230), respectively. Univariate analysis revealed children <3 years of age, hemispheric tumor location, high risk according to risk stratification, and patients who did not receive radiation therapy affected the prognosis. In multivariable analysis, hemispheric tumors (hazard ratio [HR] 2.54 [95% CI 1.11–5.80]; P = 0.01)and high risk groups (HR 3.86 [95% CI 1.28–11.60]; P = 0.01) influenced death. Finally, using conditional inference trees, the study showed that hemispheric tumor locations are truly aggressive in behavior, whereas risk stratification is associated with the prognosis of midline tumors.Conclusions:Hemispheric medulloblastoma and high-risk groups according to risk stratification were associated with poor prognosis.

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Section: Discussioncontrasting

confidence: 43%

Survival and prognostic factors in pediatric patients with medulloblastoma in southern Thailand

et al. 2018

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“…Multipronged approach combining surgery, radiation and chemotherapy remains the cornerstone for the treatment of medulloblastoma, as these tumors gives an excellent response to radiation and chemotherapy subsequent to surgical resection. [ 16 ] However, the age, histology, tumor stage, and type of surgery are the major determinant of prognosis.…”

Section: Discussionmentioning

confidence: 99%

Magnitude of neurogenic tumor burden in pediatric population: A tertiary care center study

2017

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Objective:Progress in the diagnosis and treatment of childhood neoplasm in the past few decades is one of the most gratifying achievements in the field of oncology. This study was aimed to ascertain the burden (incidence and prevalence) and histopathologic features of neurogenic tumors occurring in the pediatric population.Materials and Methods:The study evaluated a total of 492 cases of pediatric tumors over a period of 8 years from 2007 to 2015, including patients of 0–12 years of age group; attending the out-patients and in-patients Department of Pediatrics and Pediatric Surgery at Jawaharlal Nehru Medical College, AMU, Aligarh, with the complaints of tumor or tumor associated sign and symptoms. Clinical profile, hematological and histopathological examination along with immunohistochemical analysis were implicated to attain a conclusive diagnosis.Result:Out of 492 pediatric tumor cases, 255 (52%) cases were benign and 237 (48%) cases were malignant. Neurogenic tumor (brain tumors) comprised 49 (10%) of the total case, being most common malignant solid neoplasm and second most common (next to leukemia) overall malignancy, constituting 49/237 (21%) cases. Astrocytoma 22/49 (45%) cases were the most common type brain tumor followed by medulloblastoma 15/49 (31%), ependymoma 9/49 (18%), and craniopharyngioma 3/49 (6%).Conclusion:Effective management of pediatric neurogenic tumor is a multipronged approach involving effort of good Pediatric neurosurgeon, Pathologist and a host of Oncology specialists with insight into childhood neoplasms.

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“…No studies attempted to formally analyze predictors of treatment abandonment in CNS tumors. However, authors of 12 studies reported possible causes of abandonment (Table ), based on their personal experience with patients, patient records, and knowledge of patients’ backgrounds . Only one (Chinese) study conducted a questionnaire with caregivers to identify reasons for abandonment .…”

Section: Overall Resultsmentioning

confidence: 99%

The magnitude and predictors of therapy abandonment in pediatric central nervous system tumors in low‐ and middle‐income countries: Systematic review and meta‐analysis

Seah

Zhang

Halbert

et al. 2019

Pediatric Blood & Cancer

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Background Outcomes of pediatric central nervous system (CNS) tumors in low‐ to middle‐income countries (LMIC) are poorer than their high‐income counterparts. Abandonment of therapy is increasingly recognized as a key contributor to this disparity, but has been poorly quantified. We performed a meta‐analysis to determine the magnitude of abandonment in pediatric CNS tumors in LMIC, and risk factors and interventions aimed at reducing this. Patients and methods We searched seven databases for pediatric CNS tumor cohorts followed up from diagnosis and treated in LMIC. All languages were included. Two reviewers independently selected articles and extracted data on abandonment rates (ARs) and predictors. The authors were contacted for additional information. Results Of 50 660 publications, 643 in five languages met criteria for full review; 131 met analysis inclusion criteria. ARs were not reported in the majority, and a small number were available from the authors. Available ARs ranged from 0% to 59%, from 38 studies (2497 children in 14 countries), and these were quantitatively analyzed. Lower‐middle‐income countries had higher ARs than upper‐middle‐income countries (27%, 95% confidence interval [CI] 20%–36% vs 9%, 95% CI 6%–14%, P < 0.0001), with significant heterogeneity within each (LMIC I2 = 78%, P < 0.00001, UMIC I2 = 85%, P < 0.00001). Common predictors for abandonment included distance to treatment centers, financial hardship, and prognostic misconceptions. Conclusion In LMICs, ARs are highest in lower‐MICs. However, the paucity of published data limits further evaluation. Given the increasing burden of pediatric CNS tumors in LMIC, addressing deficits in abandonment reporting is critical. Consistent reporting is needed for developing interventions to improve outcomes.

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An analysis of medulloblastoma: 10 year experience of a referral institution in South India

Cited by 12 publications

References 0 publications

Survival and prognostic factors in pediatric patients with medulloblastoma in southern Thailand

Survival and prognostic factors in pediatric patients with medulloblastoma in southern Thailand

Magnitude of neurogenic tumor burden in pediatric population: A tertiary care center study

The magnitude and predictors of therapy abandonment in pediatric central nervous system tumors in low‐ and middle‐income countries: Systematic review and meta‐analysis

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