Survival and recurrence factors in adult medulloblastoma: The M.D. Anderson Cancer Center experience from 1978 to 1998

Kunschner, Lara J.

doi:10.1215/15228517-3-3-167

Cited by 13 publications

(22 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…1,4,10,22,31,32,38,40 The distribution of histological variants was also comparable to that reported by other authors, 1,7,10,19,24,26,31,34,36,38,43 with predominance of the classic histological phenotype. However, our population showed some characteristics different from other series.…”

Section: Population Studysupporting

confidence: 90%

“…These findings contrast with other authors' reports of complete resection in about half of the patients. 10,19,22,24,26,31,33,36,45 For many years, our general surgical principle has been to attempt as complete a resection of the tumor as possible, but it was also guided by what the surgeon considered prudent at the time: no attempts were made to remove the tumor from within the brainstem in cases of infiltration into the floor of the fourth ventricle or the cerebellar peduncles. This series also demonstrated that adult patients with medulloblastoma generally present with symptoms and signs indicating a posterior fossa lesion, and that the majority of patients have disease limited to the posterior fossa at the time of initial staging.…”

Section: Population Studymentioning

confidence: 99%

See 1 more Smart Citation

Survival and prognostic factors in a series of adults with medulloblastomas

Riffaud

Saïkali

Leray

et al. 2009

JNS

View full text Add to dashboard Cite

Object In this article, the authors report their experience in the management of adult patients with medulloblastoma at their institution to identify prognostic factors important for survival and disease control. Methods Between 1977 and 2005, 27 patients who were ≥ 16 years old and had medulloblastoma were treated consecutively. There were 16 women and 11 men with a median age of 21 years (range 16–54 years). Gross-total resection was performed in 21 patients, subtotal (≥ 90%) in 2, incomplete in 1, and biopsy in 3 patients. Six patients had the desmoplastic variant, and 21 patients presented with classic medulloblastoma. Staging according to the Chang classification showed 4 patients with tumors invading the brainstem (2 with Stage T3b and 2 with Stage T4), 3 patients with metastases (2 with Stage M2 and 1 with Stage M3), and 1 patient in whom the stage was unknown (Stage MX) who died 10 days postoperatively. Twenty patients were assigned to the standard-risk group and 7 to the high-risk group. All patients except the one whose status was classified as Stage MX underwent craniospinal radiotherapy at our institution. Seven patients received chemotherapy before radiotherapy. Results The 5- and 10-year overall survival rates for the present study were 81 and 62%, respectively. The median overall survival time was 17.7 years. The 5- and 10-year event-free survival rates were 72 and 57%, respectively. The median event-free survival time was 17.9 years. Univariate analysis showed that survival was significantly correlated with sex (women had a better prognosis than men) and M stage (patients without metastases had a better outcome). Patient age, duration of symptoms, Karnofsky Performance Scale score at presentation, hydrocephalus, tumor location, brainstem invasion, extent of resection, histological subtype, preradiotherapy chemotherapy, risk group, and period of presentation were not significant variables. Multivariate analysis identified sex and M stage as well as the period of presentation as independent prognostic factors for overall and event-free survival times. Eleven patients suffered tumor recurrence within a median time of 4.2 years. The posterior fossa was not the most common site of recurrence, and delayed recurrence was not rare. All patients in whom the tumor recurred have died despite aggressive treatments. The median survival time after diagnosis of recurrence was 2.5 years. Questionnaires on quality of life and cognition showed high scores in favor of limited negative effects in the perception of mental and physical health after treatment. The authors observed 1 supposed second malignancy (thyroid carcinoma) and no evidence of pituitary dysfunction. Conclusions Long-term survival is possible in adults treated for medulloblastoma. Although rare, metastasis seeding at presentation is a poor prognostic factor. The possibility of delayed recurrence necessitates close follow-up of all patients. Tumor recurrences should be treated with aggressive therapies as some patients may have sustained response. Adjuvant chemotherapy should be given to high-risk patients, but its role in reducing recurrences, particularly distant ones, remains unclear in the standard-risk group.

show abstract

Section: Population Studysupporting

confidence: 90%

Section: Population Studymentioning

confidence: 99%

Survival and prognostic factors in a series of adults with medulloblastomas

Riffaud

Saïkali

Leray

et al. 2009

JNS

View full text Add to dashboard Cite

show abstract

“…There was no recurrence or distant metastasis in the follow-up after adjuvant RT or CT. Recurrences develop mostly in posterior fossa. [23][24][25] A review of recurrence patterns indicated that recurrences occur mostly within 2 years in pediatric group. [26,27] This duration is longer for adult patients.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, adult patients do not show good tolerance against pediatric CT regimes. [23] In their study involving 32 patients, Herrlinger et al found that adjuvant vincristine, CCNU, cisplatin or methotrexate, cisplatin chemotherapies contributed to survival, although it was not statistically significant. [24] In our study, adjuvant CT was In our study, we think we could not find a statistically significant prognostic factor because of the limited number of patients.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Surgery and Craniospinal Radiotherapy for Adult Patients with Medulloblastoma

Güzelöz¹

2017

TJ Oncol

View full text Add to dashboard Cite

OBJECTIVEThe aim of the present study was to evaluate treatment outcomes for adult patients with medulloblastoma who received craniospinal irradiation following surgery at Dokuz Eylül University Radiation Oncology Department. METHODSTwelve patients were evaluated retrospectively. Median age was 31 years (range: 18-55 years). According to Chang staging system, 3 (25%) of the patients were T1, 2 (17%) were T2, 5 (42%) were T3, and 1 (8%) was T4; 1 patient could not be staged due to inadequate preoperative imaging. Tumor location, stage, presence of residual disease, duration between surgery and radiotherapy (RT), age, and sex were evaluated as prognostic factors. Statistical analyses were conducted using Kaplan-Meier method and SPSS for Windows, Version 15.0 (SPSS Inc., Chicago, IL, USA). RESULTSMedian dose was 36 Gy (range: 32-44 Gy) to craniospinal field and 54 Gy (range: 50-56 Gy) to primary tumor location. Median follow-up time was 62 months (range: 4-212 months). Five-, 10-, and 15-year overall survival rates were 79%, 63%, and 63%, and 5-, 10-and 15-year progression-free survival rates were 63%, 63%, and 63%, respectively. No statistically significant prognostic factor was found for survival rate. Three (25%) patients developed serious hematological toxicity during RT course. No grade 3 or 4 late side effect was observed. CONCLUSIONDespite the limited number of cases, results are consistent with the literature. Evaluation of features of this rare disease requires studies with larger number of.

show abstract

“…Anderson Cancer Center over a 20-year period . 30 Statistical analysis of prognostic factors and overall survival was performed for a subgroup of 28 patients who were followed exclusively at their institution, between the time of diagnosis and death or last follow-up visit. Overall survival in these 28 patients was 91% at 3 years and 84% at 5 years, whereas median survival was not reached after a median follow-up period of 168 weeks (range 9-602 weeks).…”

Section: Neurosurg Focus / Volume 14 / April 2003mentioning

confidence: 99%

De novo cerebellar medulloblastoma in a 26-year recurrence-free case of temporal glioblastoma multiforme

Fandiño¹,

Am²,

Rh³

et al. 2003

FOC

View full text Add to dashboard Cite

The authors describe a patient who survived 26 years after resection of a right temporal glioblastoma multiforme (GBM) without signs of tumor recurrence. Preoperative emergency angiography demonstrated a hypovascular mass localized in the right temporal lobe with right-to-left shift of the vascular structures. At surgery, the tumor had cystic and solid components localized in the lateral occipitotemporal gyrus, reaching the posterolateral wall of the inferior horn of the right lateral ventricle and extending to the trigone and posterior horn. The initial pathological diagnosis of a GBM was reviewed and confirmed throughout the follow-up period. Twenty-six years after surgery and subsequent radiosurgery, the patient underwent resection of a medulloblastoma localized in the right cerebellum as well as stereotactic biopsy sampling of tissue at the original GBM site. Neither radiological nor histological evidence of recurrence of the GBM could be documented. The intraoperative, histological, and radiological findings are described.

show abstract

Survival and recurrence factors in adult medulloblastoma: The M.D. Anderson Cancer Center experience from 1978 to 1998

Cited by 13 publications

References 0 publications

Survival and prognostic factors in a series of adults with medulloblastomas

Survival and prognostic factors in a series of adults with medulloblastomas

Outcomes of Surgery and Craniospinal Radiotherapy for Adult Patients with Medulloblastoma

De novo cerebellar medulloblastoma in a 26-year recurrence-free case of temporal glioblastoma multiforme

Contact Info

Product

Resources

About