Medulloblastoma and Collins' Law

Abstract

Collins' law (CL) states that the period of risk for recurrence for a tumor is the age of the patient plus 9 months. Originally a clinical observation in Wilms' tumor, CL has been applied to other tumors such as medulloblastoma (MB). Although CL does not apply to all childhood tumors, it seems to be a valid observation for childhood MB, despite several reports of violations or exceptions to CL in the literature. We sought to test CL in a large population of children with MB from the Childhood Brain Tumor Consortium (CBTC). We analyzed data from 602 children with MB, of whom 421 died and 181 were censored but alive at the last follow-up. We found 16 additional CL exceptions to supplement the 22 already present in the literature. This is both the greatest number of exceptions and the largest MB study population for CL reported to date. We provide clinical data on our 16 uncensored exceptions to CL and critically review those 22 cases cited previously in the literature. All of the CBTC exceptions were under 6 years of age at the time of initial diagnosis and were followed for an average of 7.5 years. All 16 CBTC exceptions died. Children older than 8 years of age could not be followed for a sufficient period of time to be able to state whether CL applies; as age at initial diagnosis increases, the period of observation required to determine CL validity becomes impractically long. Exceptions to CL are rare and amounted to 3.8% of 405 uncensored CBTC patients who died.(ABSTRACT TRUNCATED AT 250 WORDS)

Surgical Outcomes of Cerebellar Tumors in Children

“…The survival of the patients with medulloblastomas varies from poor to good, depending on several variables. The period of risk for recurrence, in general, can be estimated from Collin’s law, where the period of risk is the age of the patient at the time of diagnosis plus 9 months [19]. But freedom from relapse after 8 years is considered as a cure by some authors [20].…”

Brain Tumors in Children Under 3 Years of Age

“…In fact, despite the high and early mortality in children with ependymoma and PNET reported by various authors and confirmed by our experience [3, 7, 14, 15, 35, 49], if the tumor has been totally removed, the possibility of a delayed relapse is low. Exceptions to Collins’ law have been described, but these are mostly related to histologically benign tumors [38, 49, 50, 51, 52, 53]. Collins’ law seems to be a useful predictor of survival in children with medulloblastoma [54], particularly for those less than 8 years of age [52].…”

“…Exceptions to Collins’ law have been described, but these are mostly related to histologically benign tumors [38, 49, 50, 51, 52, 53]. Collins’ law seems to be a useful predictor of survival in children with medulloblastoma [54], particularly for those less than 8 years of age [52]. Benign tumors, otherwise, may recur even several years after previous surgery.…”

Late Recurrence of a Primitive Neuro-Ectodermal Tumor

“…In 1955, Collins noted that embryonic tumors like Wilms’ tumors recur within a period defined by age at diagnosis plus 9 months [5]. This postulate was based on the growth kinetics of tumorigenic embryonic tests, and has been found to be applicable to other embryonal tumors, including PNET [5].…”

“…This postulate was based on the growth kinetics of tumorigenic embryonic tests, and has been found to be applicable to other embryonal tumors, including PNET [5]. In large series of PNET, ‘violations’ of the period of risk for recurrence as defined by Collin’s law have been reported to occur in 1.4–3.8% of the patients [6, 7].…”