Are clinical parameters valuable prognostic factors in childhood primitive neuroectodermal tumors? A multivariate analysis of 105 cases.
BACKGROUND
Medulloblastoma is one of the most frequent brain tumors in children. Long-term survivors are often confronted with serious late sequelae, caused by the therapy. Therefore, prognostic markers must be identified that allow the children to be assigned to different treatment schedules according to their predicted outcome.


METHODS
The medical data of 110 children with a medulloblastoma or central primitive neuroectodermal tumor (PNET), that were admitted to the Emma Kinderziekenhuis in Amsterdam were analyzed by univariate and multivariate analyses.


RESULTS
In univariate analysis the following characteristics had a significant influence on progression free survival (PFS): (a) presence of meningeal metastases at the time of diagnosis, (b) presence of tumor cells in the cerebrospinal fluid before or after surgery, (c) extent of resection, (d) necessity for permanent cerebrospinal fluid (CSF) shunting and (e) radiation dose to the posterior fossa. On multivariate analysis only the presence of metastases and the radiation dose to the posterior fossa retained significance.


CONCLUSIONS
At the time of diagnosis, no reliable clinical prognostic markers are available for the majority of patients. Further molecular studies must be undertaken to identify such prognostic factors.
Michiels
E M
EM
Department of Pediatric Oncology, Emma Kinderziekenhuis/Academic Medical Center, P.O. Box 22700, 1100 DE, Amsterdam, The Netherlands.
Heikens
J
J
Jansen
M J
MJ
Oldenburger
F
F
Voûte
T
T
D000293:Adolescent; D001932:Brain Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008527:Medulloblastoma / Q000401:mortality / Q000473:pathology / Q000628:therapy; D015999:Multivariate Analysis; D018242:Neuroectodermal Tumors, Primitive / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D011379:Prognosis; D015996:Survival Rate