title: Recurrence in medulloblastoma - influence of clinical, histological and immunohistochemical factors.
abstract: BACKGROUND
  The therapy for medulloblastomas has gone through several changes over the years. Research has shown that patients with medulloblastoma cannot be satisfactorily stratified into risk groups based on clinical and therapeutic factors alone.
  
  
  OBJECTIVE
  To study the clinical, histological features and expression of immunohistochemical markers in medulloblastoma, and to correlate these features with recurrence rates.
  
  
  METHODS
  Sixty-three cases of medulloblastomas operated at our institute from 1996-2003 were selected and retrospectively analyzed for therapy received, histological features and immunohistochemical expression of GFAP, synaptophysin, erb B2, p53, Bcl-2 and Trk-C along with assessment of MIB-1 labeling index(LI).
  
  
  RESULTS
  The mean age of the 63 cases at presentation was 11.6 yrs. Near/Gross- total resection was achieved in 74.6% (47/63) of the cases.
  
  
  CONCLUSIONS
  We propose a clinical-histological-immunohistochemical' model for medulloblastoma where extent of resection, administration of chemotherapy, presence of gross anaplasia and c-erb B2 overexpression status are the most important predictors of recurrence rates.
authors.affiliation: Department of Neurosurgery, NIMHANS, Bangalore, India.
authors.forename: Umesh
authors.initials: U
authors.lastname: Srikantha
authors.forename: Anandh
authors.initials: A
authors.lastname: Balasubramaniam
authors.forename: Vani
authors.initials: V
authors.lastname: Santosh
authors.forename: Sampath
authors.initials: S
authors.lastname: Somanna
authors.forename: Indira Devi
authors.initials: ID
authors.lastname: Bhagavatula
authors.forename: Chandramouli Bangalore
authors.initials: CB
authors.lastname: Ashwathnarayana
mesh_terms: D000293:Adolescent; D000328:Adult; D014408:Biomarkers, Tumor / Q000378:metabolism; D002528:Cerebellar Neoplasms / Q000378:metabolism / Q000401:mortality / Q000473:pathology / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007194:India / Q000453:epidemiology; D008297:Male; D008527:Medulloblastoma / Q000378:metabolism / Q000401:mortality / Q000473:pathology / Q000628:therapy; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000378:metabolism / Q000473:pathology; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D012189:Retrospective Studies; D015996:Survival Rate; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D018719:Erb-b2 Receptor Tyrosine Kinases; D016159:Tumor Suppressor Protein p53