title: M1 Medulloblastoma: high risk at any age.
abstract: BACKGROUND
  The prognosis for children with M1 medulloblastoma (positive CSF cytology) has not been well-defined.
  
  
  METHODS
  We retrospectively reviewed the records of 285 newly diagnosed medulloblastoma patients treated between 1984 and 2006. Older children received post-operative craniospinal and tumor bed irradiation; radiotherapy for younger children depended on treatment era and physician/family preference.
  
  
  RESULTS
  55 patients were <3 years old and 230 patients were >or= 3 years old at diagnosis. We detected significant (P < 0.0001) associations between M1 disease and EFS for the entire cohort and for both younger and older patients. Among younger children, M1 patients had lower EFS than M0 (P = 0.0044).
  
  
  CONCLUSIONS
  Children <3 years old with M1 medulloblastoma fared poorly in our small series. Survival for older children with M1 disease treated with higher-dose CSI was better than that of M2/M3 patients, but still less than optimal; our findings do not support reduction in therapy for either cohort.
authors.affiliation: Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA. robertsandersmd@gmail.com
authors.forename: Robert P
authors.initials: RP
authors.lastname: Sanders
authors.forename: Arzu
authors.initials: A
authors.lastname: Onar
authors.forename: James M
authors.initials: JM
authors.lastname: Boyett
authors.forename: Alberto
authors.initials: A
authors.lastname: Broniscer
authors.forename: E Brannon
authors.initials: EB
authors.lastname: Morris
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Qaddoumi
authors.forename: Gregory T
authors.initials: GT
authors.lastname: Armstrong
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Boop
authors.forename: Robert A
authors.initials: RA
authors.lastname: Sanford
authors.forename: Larry E
authors.initials: LE
authors.lastname: Kun
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Merchant
authors.forename: Amar
authors.initials: A
authors.lastname: Gajjar
mesh_terms: D000293:Adolescent; D002528:Cerebellar Neoplasms / Q000401:mortality* / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008527:Medulloblastoma / Q000401:mortality* / Q000628:therapy*; D011379:Prognosis; D012189:Retrospective Studies; D012306:Risk; D016019:Survival Analysis; D055815:Young Adult