M1 Medulloblastoma: high risk at any age.
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.
Sanders
Robert P
RP
Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA. robertsandersmd@gmail.com
Onar
Arzu
A
Boyett
James M
JM
Broniscer
Alberto
A
Morris
E Brannon
EB
Qaddoumi
Ibrahim
I
Armstrong
Gregory T
GT
Boop
Frederick A
FA
Sanford
Robert A
RA
Kun
Larry E
LE
Merchant
Thomas E
TE
Gajjar
Amar
A
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