A review of the factors influencing the prognosis of medulloblastoma

The importance of cell differentiation

Anthony J. CaputyDepartments of Neurosurgery and Pathology, Children's Hospital National Medical Center, Georgetown University Medical Center, and the George Washington University School of Medicine, Washington, DC.

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David C. McCulloughDepartments of Neurosurgery and Pathology, Children's Hospital National Medical Center, Georgetown University Medical Center, and the George Washington University School of Medicine, Washington, DC.

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Herbert J. ManzDepartments of Neurosurgery and Pathology, Children's Hospital National Medical Center, Georgetown University Medical Center, and the George Washington University School of Medicine, Washington, DC.

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Kathleen PattersonDepartments of Neurosurgery and Pathology, Children's Hospital National Medical Center, Georgetown University Medical Center, and the George Washington University School of Medicine, Washington, DC.

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Mary Kathryn HammockDepartments of Neurosurgery and Pathology, Children's Hospital National Medical Center, Georgetown University Medical Center, and the George Washington University School of Medicine, Washington, DC.

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✓ The clinical, therapeutic, and histological features of 54 patients with medulloblastoma were analyzed retrospectively by a multivariate approach with regard to prognosis. The overall 5-year survival rate was 60%, with 48% of patients free of recurrence at 5 years. Cell differentiation, when present, was associated with a significantly longer recurrence-free period. Seventy-two percent of patients with the histological finding of cell differentiation were recurrence-free at 5 years. A marginally significant increase in the 5-year survival rate was also seen in association with differentiation. Only 34% of the patients whose tumor exhibited necrosis were alive at 5 years.

There was no statistically significant difference in 5-year survival for children under 3 years of age or for the group of children aged 5 years or under. However, a significantly larger fraction (72%) of the group aged 5 years or under had a recurrence-free period of 5 years or more. Other factors including sex, extent of surgical resection, Chang tumor stage, posterior fossa radiation dose, and adjuvant chemotherapy did not influence prognosis.

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