Large cell/anaplastic medulloblastoma is associated with poor prognosis—a retrospective analysis at a single institute

Pin I. Huang, Shih Chieh Lin, Yi Yen Lee, Donald Ming Tak Ho, Wan Yuo Guo, Kai Ping Chang, Feng Chi Chang, Muh Lii Liang, Hsin Hung Chen, Yu Ming Liu, Sang Hue Yen, Tai-Tong Wong, Yi Wei Chen

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose: Medulloblastoma (MB) is the most commonly occurring malignant pediatric brain tumor worldwide. However, a recent study found that the treatment outcomes in those with high-risk disease receiving conventional treatment were suboptimal. This study aimed to assess outcomes and treatment strategies for specific histologic subtypes of pediatric MB. Methods: A total of 114 pediatric patients (age < 20 years) diagnosed with MB between March 1998 and August 2011 were retrospectively reviewed; 52 that were treated with surgery followed by adjuvant radiotherapy (RT) and chemotherapy (CHT) were included. Results: The 5-year overall survival (OS) and relapse-free survival (RFS) rates were 73 and 69%, respectively. Median time to relapse was 17 months with a median survival time of 6 months after relapse. Patients of average risk had a better 5-year OS rate compared with high-risk patients (p = 0.027). The 5-year RFS of high-risk patients was lower compared with average risk (p = 0.038). A greater proportion of patients with large cell/anaplastic (LC/A) MB had recurrence than classic MB with 5-year RFS rate of 34 and 76%, respectively (p = 0.001), and OS rate of 56 and 76%, respectively (p = 0.04). Conclusion: High-risk group and histology of LC/A were the most significant factors associated with worse OS and RFS. Patients with LC/A-MB had higher relapse rates and worse survival than those with classic MB. LC/A-MB carries a high risk for recurrence and should be treated with the more aggressive strategies.

Original languageEnglish
Pages (from-to)1285-1294
Number of pages10
JournalChild's Nervous System
Volume33
Issue number8
DOIs
Publication statusPublished - Aug 1 2017
Externally publishedYes

Keywords

  • Chemotherapy
  • Craniospinal irradiation
  • Craniotomy
  • Large cell/anaplastic medulloblastoma
  • Multidisciplinary treatments
  • Radiotherapy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

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  • Cite this

    Huang, P. I., Lin, S. C., Lee, Y. Y., Ho, D. M. T., Guo, W. Y., Chang, K. P., Chang, F. C., Liang, M. L., Chen, H. H., Liu, Y. M., Yen, S. H., Wong, T-T., & Chen, Y. W. (2017). Large cell/anaplastic medulloblastoma is associated with poor prognosis—a retrospective analysis at a single institute. Child's Nervous System, 33(8), 1285-1294. https://doi.org/10.1007/s00381-017-3435-9