Survival of Children with Infratentorial Neuroglial Tumors

El, Sobel; Fh, Gilles; Leviton, Alan; Cj, Tavaré; Hedley‐Whyte, E. Tessa; Lb, Rorke; Ls, Adelman

doi:10.1097/00006123-199607000-00010

Cited by 18 publications

(10 citation statements)

References 21 publications

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“…In contrast, many previous studies reported no overall difference in survival by gender. These include a study of 63 patients by Preston‐Martin et al 6, which did not distinguish MB from PNET, and another report of a sample of several hundred children, which included neuroglial tumors in the analysis 7. In addition to the smaller sample sizes, it is possible that an interaction between age and gender that was not accounted for also contributed to a lack of overall significant survival difference in these studies.…”

Section: Discussionmentioning

confidence: 99%

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Gender affects survival for medulloblastoma only in older children and adults: A study from the surveillance epidemiology and end results registry

Curran

Sainani

et al. 2008

Pediatric Blood & Cancer

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Background. Males have a higher incidence of medulloblastoma (MB) than females, but the effect of gender on survival is unclear. Studies have yielded conflicting results, possibly due to small sample sizes or differences in how researchers defined MB. We aimed to determine the effect of gender on survival in MB using a large data set and strict criteria for defining MB. Procedure. A sample of 1,226 subjects (763 males and 463 females) was identified from 1973 to 2002, using the Surveillance Epidemiology and End Results (SEER-9) registry. MB was strictly defined to exclude non-cerebellar embryonal tumors (primitive neuro-ectodermal tumors). Because children <3 years of age are known to have worse survival, patients were stratified by age <3 years at diagnosis (95 males, 82 females) and >3 years (668 males, 381 females). Results. Overall, there was no significant difference in survival between males and females (log rank P ¼ 0.22). However, among subjects >3 years, females had significantly greater survival than males (log rank P ¼ 0.02). In children <3 years, there was a non-significant trend toward poorer survival in females (median survival: males 27 months, females 13 months; log rank P ¼ 0.24). This interaction between age group and gender was statistically significant (P ¼ 0.03). Conclusion. Females with MB have a survival advantage only in subjects >3 years. In children <3 years, females may even have poorer outcome. The effect of gender on survival and incidence in MB warrants additional biologic investigation, and may differ in very young children with MB.

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Section: Discussionmentioning

confidence: 99%

“…While some studies found that males have poorer survival than females 3, 4, others found no gender difference in survival 5–7. Previous studies have been limited by small sample size, with some series examining patients only from a single institution 3, likely contributing to these conflicting conclusions.…”

Section: Introductionmentioning

confidence: 99%

Gender affects survival for medulloblastoma only in older children and adults: A study from the surveillance epidemiology and end results registry

Curran

Sainani

et al. 2008

Pediatric Blood & Cancer

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“…This system was significantly prognostically in the 43 tumors studied, but it was never adopted widely. Subsequent investigations generally have supported the hypothesis that anaplasia, elevated mitotic rate, apoptosis, and necrosis are associated with poor clinical outcomes in patients with medulloblastoma,15–17 but no formal grading system has evolved, and patients with medulloblastoma currently are not stratified by histologic grade.…”

Section: Discussionmentioning

confidence: 99%

Histopathologic grading of medulloblastomas

Eberhart

Kepner

Goldthwaite

et al. 2002

Cancer

287

157

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“…The p value calculated for patient survival less than versus more than 10 years was >0.05 and hence not significant. There are conflicting reports of the relationship between age and the length of survival [10, 11]. Garcia et al [2]reported worse survival in children under the age of 5 years when compared with children older than 5 years of age.…”

Section: Discussionmentioning

confidence: 99%

“…It is an important positive factor in relation to recurrence and the patient’s survival [2, 3, 6, 10, 11, 13, 23, 24]. Despite this, some authors still contend that a complete resection is not essential, citing several cases in which there was no tumor recurrence for several years after partial removal [25, 26, 27, 28].…”

Section: Discussionmentioning

confidence: 99%

Prognostic Factors for Cerebellar Astrocytomas in Children: A Study of 102 Cases

Desai¹,

Nadkarni²,

Muzumdar³

et al. 2001

Pediatr Neurosurg

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Objective: To evaluate the prognostic factors influencing the length of survival of pediatric patients with cerebellar astrocytomas. Methods: The clinical data of 102 patients under the age of 12 years with cerebellar astrocytomas were retrospectively analyzed. The radiological features, surgical findings, histology and adjuvant radiotherapy were reviewed. Patients were followed up on an outpatient basis. Computerized tomography (CT) scans of the brain were performed to detect recurrence. Results: The age of the patients at presentation varied from 10 months to 12 years. The mean age at presentation was 7 years and 11 months. The average duration of symptoms was 5.8 months. The clinical features were predominantly related to intracranial hypertension and the location of the tumor. Twenty-six tumors were located in the vermis and 76 in the cerebellar hemisphere. The brain stem was involved in 20 patients. All 102 patients had a preoperative contrast-enhanced CT scan. Midline vermian tumors were predominantly solid and enhancing, whilst the hemispheric tumors were cystic and nonenhancing. The tumors were graded into three subgroups based on histological characteristics: pilocytic astrocytoma, low-grade fibrillary astrocytoma and high-grade fibrillary astrocytoma. Total, radical and subtotal excision, as determined by the surgical impression, were performed in 82, 16 and 4 patients, respectively. Postoperative radiotherapy was administered to 12 patients. CSF diversion was carried out in 11 of 79 cases who had moderate to severe hydrocephalus. Conclusions: Our study has shown that the location of the tumor (p < 0.05), histological grade (p < 0.001) and the extent of tumor resection (p < 0.001) have a significant and definitive relationship to the length of survival of pediatric patients with cerebellar astrocytomas. The patient’s age (p > 0.05) does not influence the outcome. We could not evaluate the effect of brain stem involvement and adjuvant radiotherapy in our study because of the small sample size.

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Survival of Children with Infratentorial Neuroglial Tumors

Abstract: Factor scores provide clinically useful quantitative estimates of survival probability that are more specific and accurate than the general estimates based on the conventional diagnosis alone.

Cited by 18 publications

References 21 publications

Gender affects survival for medulloblastoma only in older children and adults: A study from the surveillance epidemiology and end results registry

Gender affects survival for medulloblastoma only in older children and adults: A study from the surveillance epidemiology and end results registry

Histopathologic grading of medulloblastomas

Prognostic Factors for Cerebellar Astrocytomas in Children: A Study of 102 Cases

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