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Survival and Prognostic Factors in Pediatric Patients with Medulloblastoma in Southern Thailand
BACKGROUND: The current prognosis of medulloblastoma in children is better because of technological advancements and improvements in treatment strategies and genetic investigations. However, there is a lack of studies that focus on medulloblastoma in Thailand. The aims of our study were to conduct a...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6057209/ https://www.ncbi.nlm.nih.gov/pubmed/30090127 http://dx.doi.org/10.4103/jpn.JPN_111_17 |
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author | Nalita, Navaporn Ratanalert, Sanguansin Kanjanapradit, Kanet Chotsampancharoen, Thirachit Tunthanathip, Thara |
author_facet | Nalita, Navaporn Ratanalert, Sanguansin Kanjanapradit, Kanet Chotsampancharoen, Thirachit Tunthanathip, Thara |
author_sort | Nalita, Navaporn |
collection | PubMed |
description | BACKGROUND: The current prognosis of medulloblastoma in children is better because of technological advancements and improvements in treatment strategies and genetic investigations. However, there is a lack of studies that focus on medulloblastoma in Thailand. The aims of our study were to conduct a survival analysis and to identify the prognostic factors of pediatric medulloblastoma. MATERIALS AND METHODS: Fifty-five children, with medulloblastoma, were eligible for analysis between 1991 and 2015. We retrospectively reviewed both the clinical and the histological data. Survival curves were constructed using the Kaplan–Meier method. For comparisons of dichotomous factors, between groups, the log-rank test was used to determine survival. The Cox proportional hazard regression model was used to identify the univariate and multivariate survival predictors. RESULTS: The mortality rate was 49.1% in this study. The median follow-up time was 68.8 months (range: 1–294 months). The 5-year overall survival rate and median survival time were 53.8% (95% CI 38.7–66.7) and 80 months (95% CI 23–230), respectively. Univariate analysis revealed children <3 years of age, hemispheric tumor location, high risk according to risk stratification, and patients who did not receive radiation therapy affected the prognosis. In multivariable analysis, hemispheric tumors (hazard ratio [HR] 2.54 [95% CI 1.11–5.80]; P = 0.01)and high risk groups (HR 3.86 [95% CI 1.28–11.60]; P = 0.01) influenced death. Finally, using conditional inference trees, the study showed that hemispheric tumor locations are truly aggressive in behavior, whereas risk stratification is associated with the prognosis of midline tumors. CONCLUSIONS: Hemispheric medulloblastoma and high-risk groups according to risk stratification were associated with poor prognosis. |
format | Online Article Text |
id | pubmed-6057209 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-60572092018-08-08 Survival and Prognostic Factors in Pediatric Patients with Medulloblastoma in Southern Thailand Nalita, Navaporn Ratanalert, Sanguansin Kanjanapradit, Kanet Chotsampancharoen, Thirachit Tunthanathip, Thara J Pediatr Neurosci Original Article BACKGROUND: The current prognosis of medulloblastoma in children is better because of technological advancements and improvements in treatment strategies and genetic investigations. However, there is a lack of studies that focus on medulloblastoma in Thailand. The aims of our study were to conduct a survival analysis and to identify the prognostic factors of pediatric medulloblastoma. MATERIALS AND METHODS: Fifty-five children, with medulloblastoma, were eligible for analysis between 1991 and 2015. We retrospectively reviewed both the clinical and the histological data. Survival curves were constructed using the Kaplan–Meier method. For comparisons of dichotomous factors, between groups, the log-rank test was used to determine survival. The Cox proportional hazard regression model was used to identify the univariate and multivariate survival predictors. RESULTS: The mortality rate was 49.1% in this study. The median follow-up time was 68.8 months (range: 1–294 months). The 5-year overall survival rate and median survival time were 53.8% (95% CI 38.7–66.7) and 80 months (95% CI 23–230), respectively. Univariate analysis revealed children <3 years of age, hemispheric tumor location, high risk according to risk stratification, and patients who did not receive radiation therapy affected the prognosis. In multivariable analysis, hemispheric tumors (hazard ratio [HR] 2.54 [95% CI 1.11–5.80]; P = 0.01)and high risk groups (HR 3.86 [95% CI 1.28–11.60]; P = 0.01) influenced death. Finally, using conditional inference trees, the study showed that hemispheric tumor locations are truly aggressive in behavior, whereas risk stratification is associated with the prognosis of midline tumors. CONCLUSIONS: Hemispheric medulloblastoma and high-risk groups according to risk stratification were associated with poor prognosis. Medknow Publications & Media Pvt Ltd 2018 /pmc/articles/PMC6057209/ /pubmed/30090127 http://dx.doi.org/10.4103/jpn.JPN_111_17 Text en Copyright: © 2018 Journal of Pediatric Neurosciences http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Nalita, Navaporn Ratanalert, Sanguansin Kanjanapradit, Kanet Chotsampancharoen, Thirachit Tunthanathip, Thara Survival and Prognostic Factors in Pediatric Patients with Medulloblastoma in Southern Thailand |
title | Survival and Prognostic Factors in Pediatric Patients with Medulloblastoma in Southern Thailand |
title_full | Survival and Prognostic Factors in Pediatric Patients with Medulloblastoma in Southern Thailand |
title_fullStr | Survival and Prognostic Factors in Pediatric Patients with Medulloblastoma in Southern Thailand |
title_full_unstemmed | Survival and Prognostic Factors in Pediatric Patients with Medulloblastoma in Southern Thailand |
title_short | Survival and Prognostic Factors in Pediatric Patients with Medulloblastoma in Southern Thailand |
title_sort | survival and prognostic factors in pediatric patients with medulloblastoma in southern thailand |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6057209/ https://www.ncbi.nlm.nih.gov/pubmed/30090127 http://dx.doi.org/10.4103/jpn.JPN_111_17 |
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