CLINICS

Clinics (Sao Paulo). 2017 May; 72(5): 294-304.
doi:10.6061/clinics/2017(05)07

Copyright © 2017 CLINICS

Risk factors for the prognosis of pediatric medulloblastoma: a retrospective analysis of 40 cases

Jianzhong Yu I , Rui Zhao II , Wei Shi I * , Hao Li I *

Department of Neurosurgery, Children’s Hospital of Fudan University, Shanghai, China

Children’s Hospital of Fudan University, Shanghai, China

*Corresponding authors. E-mail: happyronan@hotmail.com / lihao7272@163.com

received November 28, 2016; revised December 30, 2016; accepted February 24, 2017.

Abstract

OBJECTIVES:

In this study, we evaluated the association of molecular subtypes, clinical characteristics and pathological types with the prognosis of patients with medulloblastoma.

METHODS:

We analyzed forty patients with medulloblastoma who underwent surgical resection at our center between January 2004 and June 2014. Risk factors associated with survival, disease progression and recurrence were analyzed with a univariate Cox regression analysis, and the identified significant risk factors were further analyzed by Kaplan-Meier survival curves.

RESULTS:

Factors associated with overall survival included M stage (p=0.014), calcification (p=0.012), postoperative treatment, postoperative Karnofsky Performance Scale (KPS) score (p=0.015), and molecular subtype (p=0.005 for WNT and p=0.008 for SHH). Number of symptoms (p=0.029), M stage (p<0.001), and postoperative radiotherapy (p=0.033) were associated with disease progression. Patients with the WNT or SHH subtype had better survival outcomes than patients with non-WNT/SHH subtypes. Risk factors for disease progression-free survival were symptoms >2 and ≥M1 stage without postoperative radiotherapy. The risk of recurrence increased with advanced M stage. Protective factors for recurrence included M0 stage and a combination of chemotherapy and radiotherapy.

CONCLUSION:

We identified the risk factors associated with survival, disease progression and recurrence of medulloblastoma patients. This information is helpful for understanding the prognostic factors related to medulloblastoma.

Keywords: Child, Clinical Factors, Medulloblastoma, Molecular Phenotype, Overall Survival Time, Prognosis


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