Posterior fossa medulloblastoma in childhood: treatment results and a proposal for a new staging system.
Seventy-two children with posterior fossa medulloblastoma were diagnosed at the Hospital for Sick Children, Toronto, from 1977 to 1987 and treated by standard methods. The 5- and 10-year survival and disease-free survival rates were 71% and 63%, and 64% and 63%, respectively. Total tumor resection, as determined by the surgeon was the most significant favorable prognostic factor. Post-operative meningitis, a residual enhancing mass lesion on the post-operative, pre irradiation CT scan and dissemination to the brain or cord at diagnosis were unfavorable factors. These four easily definable factors were used to define a staging system with prognostic significance. Five-year disease-free survival rates were for Stage I (total resection, no adverse factor) 100%, Stage II (total resection with one or more adverse factor or less than total resection with no other adverse factor) 78%, and Stage III (less than total resection with one or more adverse factor) 18%. Evaluation of treatment results in medulloblastoma requires that these prognostic factors be known.
Department of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada.
D
D
Jenkin
K
K
Goddard
D
D
Armstrong
L
L
Becker
M
M
Berry
H
H
Chan
M
M
Doherty
M
M
Greenberg
B
B
Hendrick
H
H
Hoffman
D000293:Adolescent; D002528:Cerebellar Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003388:Cranial Fossa, Posterior; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008527:Medulloblastoma / Q000453:epidemiology / Q000401:mortality / Q000628:therapy*; D009367:Neoplasm Staging; D009864:Ontario / Q000453:epidemiology; D012044:Regression Analysis; D012189:Retrospective Studies; D016019:Survival Analysis; D015996:Survival Rate