Late recurrence of primitive neuroectodermal Tumor/Medulloblastoma

Lefkowitz, Ilene B.; Packer, Roger J.; Ryan, Stephen G.; Shah, Narin; Alavi, Jane Β.; Rorke, Lucy B.; Sutton, Leslie N.; Schut, Luis

doi:10.1002/1097-0142(19880815)62:4<826::aid-cncr2820620431>3.0.co;2-m

Cited by 35 publications

(10 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Three relapses occurred after 4 years. Similar late recurrences have been reported previously and account for 2-10% of treatment failures in medulloblastoma (Latchaw et al, 1985;Lefkowitz et al, 1988). Regardless of the circumstances of detection, the disease-free time correlated positively with survival time after recurrence.…”

Section: Discussionsupporting

confidence: 87%

Improving survival in recurrent medulloblastoma: earlier detection, better treatment or still an impasse?

Bouffet

Doz²,

Demaille³

et al. 1998

Br J Cancer

View full text Add to dashboard Cite

Summary Early detection of relapse has been advocated to improve survival in children with recurrent medulloblastoma. However, the prognostic factors and the longer term outcome of these patients remains unclear. Pattern of recurrences were analysed in three consecutive protocols of the Societe Frangaise d'Oncologie Pediatrique . A uniform surveillance programme including repeated lumbar puncture combined with computerized tomography (CT) or magnetic resonance imaging (MRI) scan was applied for all registered patients. Forty-six out of 116 patients had progressive or recurrent disease. The median time from diagnosis to recurrence was 10.5 months and 76% relapses occurred during the first 2 years. Seventeen patients had asymptomatic relapses that were detected by the surveillance protocol. Forty-one patients were treated at time of progression. Twenty-three responded to salvage therapy and 11 achieved a second complete remission. The median survival time after progression was 5 months (<1-41 months), and only two patients remained alive at time of followup. Length of survival is primarily related to some specific patterns of relapse (time from diagnosis to recurrence, circumstances of relapse, extent of relapse) and to the response to salvage therapy. No evidence of long-term benefit appeared from any form of treatment.

show abstract

Section: Discussionsupporting

confidence: 87%

Improving survival in recurrent medulloblastoma: earlier detection, better treatment or still an impasse?

Bouffet

Doz²,

Demaille³

et al. 1998

Br J Cancer

View full text Add to dashboard Cite

show abstract

“…Finally, we did not find Collin's Law to be a useful concept in medulloblastoma patients and suggest it be abandoned. 20,33 The most common cause of a recurrent enhancing mass was recurrent tumor and not radiation-induced necrosis or a radiation-induced neoplasm.…”

Section: Discussionmentioning

confidence: 99%

“…17 This law has been a successful predictor of survival for some children with brain tumor and a poor predictor for others. [18][19][20] We noted three unexpected issues while treating medulloblastoma patients, which prompted us to undertake this study. First, we encountered a patient (diagnosed as a child) presenting with a recurrence a very long time after the initial diagnosis thus "violating" Collins Law [hence, the designation "Collin's Law Violator" (CLV)].…”

mentioning

confidence: 99%

Population-based Study of Medulloblastoma: Outcomes in Alberta from 1975 to 1996

Roldán

Brasher

Vecil

et al. 2008

Can. j. neurol. sci.

View full text Add to dashboard Cite

Medulloblastoma is the most common malignant brain tumor of the central nervous system (CNS) in children, accounting for approximately 20% of all pediatric brain tumors.1,2 It is comparatively rare in adults, with a reported incidence rate of 0.05/100,000 per year, accounting for 1% of all primary tumors of the CNS. 3,4 There are few reported studies concerning adults and when reported, adults constitute a small part of the study group. [5][6][7] Previous studies of outcomes in medulloblastoma patients are based on case series or institutional experiences which were limited by referral and selection biases. 8,9 To our knowledge, there are no population-based studies of children and ABSTRACT: Background: The purpose of this study was to determine incidence, survival rate, and prognostic factors as well as the frequency of Collins' Law Violators (CLVs) in an unselected population of medulloblastoma patients. Collins' Law dictates that 'cure' of a child with a tumor occurs after a period that includes the child's age at diagnosis plus 9 months. Methods: Using the Alberta Cancer Registry a population-based review identified 49 patients with medulloblastoma (19 adults, 30 children) diagnosed from 1975-96. Pathology was reviewed in all cases. All patients had surgical resection, followed by radiotherapy in 47 patients and chemotherapy in 17. Results: The overall 5-year survival was 50%. There was a trend for the extent of resection to be associated with a longer survival (Long rank test, p< 0.06) but this was not significant. Tumor recurrence occurred a median of 22.4 months (range, 6.4-192.3) after diagnosis and median survival after recurrence was 9.3 months (range, 0.4-64.9). The survival curve did not appear to plateau but was affected by tumor-related deaths in 3 (21.4%) of the 21 long-term survivors diagnosed in childhood. These three patients had recurrences a mean of 11.7 years after diagnosis and are designated as CLVs. Conclusions: The survival rate in an unselected population of patients with medulloblastoma is poor. Aggressive resection of the tumors prolongs survival. The Collins' Law Violators were relatively common and we suggest this concept be abandoned in medulloblastoma. RÉSUMÉ: Étude de population sur le médulloblastome en Alberta de 1975 à 1996.Contexte : Le but de cette étude était d'évaluer l'incidence, le taux de survie et les facteurs influençant le pronostic ainsi que la fréquence des contrevenants à la loi de Collins dans une population non sélectionnée de patients atteints de médulloblastome. Selon la loi de Collins, un enfant atteint d'une tumeur est guéri après un temps défini par l'âge de l'enfant au moment du diagnostic plus 9 mois. Méthodes : Nous avons identifié 49 patients atteints de médulloblastome (19 adultes et 30 enfants) dans le Alberta Cancer Registry, entre 1975 et 1996. L'anatomopathologie a été révisée dans tous les cas. Tous les patients avaient subi une résection chirurgicale suivie de radiothérapie chez 47 patients et de chimiothérapie chez 17 patients. Résultats : La su...

show abstract

“…There are over 40 other reported exceptions to Collin's law as applied to medulloblastoma in the literature, [5][6][7][8] with exceptions ranging up to 19 years. 8 It would seem therefore that the term 'cure' should be used cautiously in these patients and that long term vigilance may allow earlier diagnosis of recurrent disease.…”

Section: Discussionmentioning

confidence: 99%