Decline in incidence of medulloblastoma in children (original) (raw)

Incidence of medulloblastoma in Canadian children

Journal of Neuro-Oncology, 2014

Medulloblastoma is the most common malignant brain tumor in children. There was a perception of pediatric neuro-oncologists that the incidence had declined in Canada. An epidemiological survey was undertaken to determine the incidence of this tumor in Canada and if a change had indeed occurred. All patients 14 years and under diagnosed with medulloblastoma from 1990 to 2009 inclusive in Canada were included. Data collected included date of diagnosis, age at diagnosis, gender, stage, pathology, treatment, recurrence and current status. Data were analysed for change in incidence over time. Data were obtained on 574 eligible patients. The mean overall incidence per 1,000,000 persons was 4.82 (95 % CI 4.28-5.35) for the study time period. The mean age at diagnosis was 5.8 years, and there was a male predominance. Although there was an increase in incidence over the first three time periods (24 % for 1990-1994, 27.5 % for 1995-1999, 27.7 % for 2000-2004), the most recent time period (2005-2009) showed a decrease (21 %). This was true for male children while the incidence was stable for females. The mean incidence rate was double for children under the age of 5 years (7.92 per million) compared to those over 5 years (3.64 per million).This study showed that from 1990 to 2009 the incidence of medulloblastoma was relatively stable, with a slight decrease in the last five-year time period.

Medulloblastoma in children - the Ottawa experience

Child's Nervous System, 2000

A retrospective review of 36 children diagnosed with medulloblastoma in the Ottawa area between 1974 and 1997 was completed (mean age 7.8±4.2 years, range 1.2-15.3 years). Via a suboccipital approach, complete tumor resection was achieved in 75% and subtotal resection (>90%) in 25%, without any operative mortality. The tumor was located in the vermis in 39% and in the cerebellar hemisphere in 11%; it occupied both locations in 50%. In 47% of the children a ventriculoperitoneal shunt was required. Postoperatively, craniospinal radiation at 3600 cGy with a boost to the posterior fossa was administered. Chemotherapy was used in 56%. The 1-year survival rate was 92%, and survival plateaued at 54% at 5 years. Children less than 3 years of age fared worse than those over 3 years old. While the male-to-female ratio was 1.6:1, there was no gender difference in survival. Chang's classification was used to grade the tumors. T stage did not have an impact on survival, but M stage did. No statistically significant difference in surviv-al was found between the patients who had a total resection and those who had a subtotal resection. There was no difference in survival in terms of tumor location, hydrocephalus or ventriculoperitoneal shunt. Chemotherapy showed no survival benefit. The recurrence rate was 26%, and its timing followed Collin's law. Recurrence led to death within 1-9 months. GH deficiency was diagnosed in 5 patients and hypothyroidism in 4 patients. The mean follow-up time was 4.4±3.7 years, with a range of 2.5 months to 16.5 years. Fourteen patients died, 5 were lost to follow-up, and 7 were transferred to adult care without persistent disease. Ten children are presently being followed up by the Neuro-oncology Clinic. Four children continue to be followed through psychology services. Our results are comparable to those in larger series, and are similar to those of the Montreal Children's Hospital.

Childhood medulloblastoma in Denmark 1960-1984

Child's Nervous System, 1999

Brain tumours are the second most common tumours in children after leukaemia. In Denmark the incidence of brain tumours in children is about 3.2×100.000 in children less than 15 years of age [17]. Astrocytomas are most common , followed by medulloblastomas and ependymomas. Medulloblastomas account for about 20% of the brain tumours [17]. Today they are sometimes classified as primitive neuroectodermal (PNET) tumours. The standard treatment has been surgery, most often with only partial removal or biopsy of the tumour, followed by radiotherapy and/or chemotherapy. In earlier years the prognosis was

Survival of children with medulloblastoma in Canada diagnosed between 1990 and 2009 inclusive

Journal of Neuro-Oncology, 2015

The treatment of medulloblastoma, the most common malignant brain tumor in children, has evolved over the last few decades. The objectives of this paper were to determine the survival of pediatric medulloblastoma in Canada, to determine if there has been an improvement in the survival rates between the years of 1990 and 2009, inclusive, and to determine prognostic factors for survival. All patients under the age of 18 years diagnosed with medulloblastoma from 1990 to 2009, inclusive, in Canada were included. Data collected included date of diagnosis, age at diagnosis, gender, stage, pathology, treatment, recurrence and current status. From these, survival rates were determined. Data were obtained on 628 eligible patients. The overall 5-year survival rate for the study time period was 69.2 ± 3.3 %. The survival rate increased during the interval (85.7 ± 5.5 % vs 76.1 ± 2.7 % and 60.8 ± 3 % respectively, p = 0.001). Histologic medulloblastoma subtype and M stage of disease did not result in significant differences in survival. Despite changes in approaches to therapy, we demonstrate a steady survival rate for children with medulloblastoma after 1996. In our analyses, age over 14 years was associated with a higher survival rate.

Medulloblastoma in children: a 32-year experience from a single institution

Journal of Neuro-oncology, 2008

We retrospectively evaluated 203 patients newly diagnosed with medulloblastoma between 1975 and 2006. All patients underwent surgical resection and after surgery were treated with a combination of radiotherapy and chemotherapy. CCNU-based protocols were used in the early years, with CDDP+VP16 being used more recently. Radiotherapy was used in patients older than three years of age according to the protocols. One hundred fifteen patients had total surgical resection, 78 had subtotal resection, and 4 patients had only a biopsy. Every patient received chemotherapy: 124 with the CCNU-based protocol, 75 with CDDP+VP16, and 4 with other protocols. Overall (OS) and event free-survival (EFS) rates were 43.1 and 41.9% in the whole group, with a median follow-up time of 8 years. OS rates for patients with and without spinal seeding were 30 and 63.1% (P = 0.0002). OS rates for males and females were 36.2 and 54.7% (P = 0.03). OS rates for patients receiving the CCNU and CDDP+VP16 protocols were 41.1 and 45%.

Medulloblastomas in childhood: histological factors influencing patients' outcome

Child's Nervous System, 1987

Childhood treated from 1965 through 1981 were reviewed, and the correlation between histological findings of medulloblastomas and clinical course of the patients was studied. Thirty-five patients died but the remaining 30 are alive and without clinical evidertce of recurrence 5 years or more after surgery. Certain histological features on light microscopic examinations (e.g., pleomorphism of tumor cells; nuclear-cytoplasmic ratio, mitotic index, degree of vascularity and endothelial proliferation) do influence patient outcome with statistical significance (P<0.05). Thirty out of 65 medulloblastomas were examined further, using immunohistochemical methods with glial fib'rillary acidic protein (GFAP), neuron specific enolase (NSE), and factor VIII/vW factor (FVIII/vWF). GFAP stain was negative in 20%, NSE stain in 13.3% and F VIII/vWF stain in 16.7% of the medulloblastomas studied. "Desmoplastic" medulloblastomas showed a strong tendency toward positive NSE and GFAP staining in the glomerular portion. There was no correlation between patient outcome and the results of applied immunohistochemical studies. Our data indicate that certain histological features may influence patient outcome, but the degree and pattern of cellular differentiation do not predict outcome.

The Treatment Outcomes in Children with Medulloblastoma

The Journal of Pediatric Academy, 2020

Background: Medulloblastoma is the most common central nervous system tumor in childhood. This study aims to evaluate the clinical features, treatments, and outcomes of pediatric patients diagnosed with medulloblastoma Materials and Method:Between 2006 and 2019, the medical records of children with medulloblastoma were reviewed retrospectively. Patients who died after surgery, before chemotherapy or radiotherapy were not included in the survival analysis Results: During the study period, 38 children were diagnosed with medulloblastoma. Twenty-one of the patients were male (55.3%) and 17 were female (44.7%). The ages of the children ranged from 3 months to 17 years (median age 8 years). The ages of five patients were under 3 years (13.1%). The most common complaints were headache (n: 26, 68.4%), imbalance (n: 21, 55.3%), and vomiting (n: 20, 52.6%). The mass sizes ranged between 3 and 6 cm in 32 patients (84.2%). At the time of diagnosis, 5 patients had seeding metastasis (13.1%). Th...