Flow cytometric DNA analysis of medulloblastoma.Prognostic implication of aneuploidy

Abstract

Paraffin-embedded surgical specimens from 26 infants and children with medulloblastomas treated between 1972 and 1981 were examined for DNA ploidy by flow cytometry (FCM). All patients received a standard treatment (a combination of maximum debulking of medulloblastoma and postoperative craniospinal irradiation with a posterior fossa boost of 5000 rad or more). They were studied to correlate the results of the findings of FCM DNA analysis with their final outcome, DNA ploidy, and extent of tumor resection. All seven patients with totally resected aneuploid medulloblastoma are alive, whereas only one of six patients with subtotally resected diploid medulloblastoma is alive (P = 0.0047). The current study suggests both DNA ploidy and extent of surgical resection are the most important determinant of patients' prognosis. Patients in selected group, particularly those with subtotally resected diploid tumor, are advised to undergo aggressive adjuvant chemotherapy.

Bone metastases of medulloblastoma in childhood; correlation with flow cytometric DNA analysis

“…When G2/M peak is more than 20% of total cells, it is considered to be tetraploid. The patients with aneuploid medulloblastoma have shown significantly better survival and lower rate of recurrence than those with diploid medulloblastomas [7,8]. The significance of DNA ploidy relating to the incidence of bone metastases, however, is not known.…”

“…The influence of DNA pattern of medulloblastoma on patient's outcome has been reported from our institution [7,8]. The present data which concerns our more recent patients who were diagnosed and followed by CT scans, again demonstrates the significance of DNA ploidy in the outcome of patients with medulloblastomas: DNA aneuploid tumors are associated with better prognosis.…”

“…Incompletely resected diploid tumors are in the highest risk group for recurrence [7]. It is very important to maintain close surveillance of these patients not only with frequent neuroimaging testing (CT, magnetic resonance imaging, and myelography) and CSF cytology examinations, but also with bone scans for a minimum of 5 years.…”

“…The DNA analysis of each tumor was conducted using archival formalin-fixed and paraffin-embedded tissues and flow cytometry as described previously [7,8]. DNA histograms were carefully analysed and DNA ploidy of each patient was determined without prior knowledge of patients' course.…”

Craniospinal Radiotherapy in Adult Medulloblastoma

“…Biological markers such as TrkC, C-MYC expression, and HER2, have been evaluated as independent predictors in medulloblastoma outcome but have not yet been incorporated into stratification schemes [11,15,16,20,24,29,33,35,38,39]. Besides, mainly MDM2 overexpression is found to be associated with short survival in adults with medulloblastoma [12].…”