Survival and prognostic factors of early childhood medulloblastoma: An international meta-analysis

Stefan Rutkowski, Katja Von Hoff, Angela Emser, Isabella Zwiener, Torsten Pietsch, Dominique Figarella-Branger, Felice Giangaspero, David W. Ellison, Maria Luisa Garre, Veronica Biassoni, Richard G. Grundy, Jonathan L. Finlay, Girish Dhall, Marie Anne Raquin, Jacques Grill

Research output: Contribution to journalArticle

Abstract

Purpose: To assess the prognostic role of clinical parameters and histology in early childhood medulloblastoma. Patients and Methods: Clinical and histologic data from 270 children younger than age 5 years diagnosed with medulloblastoma between March 1987 and July 2004 and treated within prospective trials of five national study groups were centrally analyzed. Results: Two hundred sixty children with medulloblastoma and specified histologic subtype were eligible for analysis (median age, 1.89 years; median follow-up, 8.0 years). Rates for 8-year event-free survival (EFS) and overall survival (OS) were 55% and 76%, respectively, in 108 children with desmoplastic/nodular medulloblastoma (DNMB) or medulloblastoma with extensive nodularity (MBEN); 27% and 42%, respectively, in 145 children with classic medulloblastoma (CMB); and 14% and 14%, respectively, in seven children with large-cell/anaplastic (LC/A) medulloblastoma (P <.001). Histology (DNMB/MBEN: hazard ratio [HR], 0.44; 95% CI, 0.31 to 0.64; LC/A medulloblastoma: HR, 2.27; 95% CI, 0.95 to 5.54; P <.001 compared with CMB), incomplete resection and metastases (M0R1: HR, 1.86; 95% CI, 1.29 to 2.80; M+: HR, 2.28; 95% CI, 1.50 to 3.46; P <.001 compared with M0R0), and national group were independent prognostic factors for EFS, and OS. The HRs for OS ranged from 0.14 for localized M0 and DNMB/MBEN to 13.67 for metastatic LC/A medulloblastoma in different national groups. Conclusion: Our results confirm the high frequency of desmoplastic variants of medulloblastomas in early childhood and histopathology as a strong independent prognostic factor. A controlled de-escalation of treatment may be appropriate for young children with DNMB and MBEN in future clinical trials.

Original languageEnglish
Pages (from-to)4961-4968
Number of pages8
JournalJournal of Clinical Oncology
Volume28
Issue number33
DOIs
Publication statusPublished - Nov 20 2010

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Medulloblastoma
Meta-Analysis
Survival
Disease-Free Survival
Histology

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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Rutkowski, S., Von Hoff, K., Emser, A., Zwiener, I., Pietsch, T., Figarella-Branger, D., ... Grill, J. (2010). Survival and prognostic factors of early childhood medulloblastoma: An international meta-analysis. Journal of Clinical Oncology, 28(33), 4961-4968. https://doi.org/10.1200/JCO.2010.30.2299

Survival and prognostic factors of early childhood medulloblastoma : An international meta-analysis. / Rutkowski, Stefan; Von Hoff, Katja; Emser, Angela; Zwiener, Isabella; Pietsch, Torsten; Figarella-Branger, Dominique; Giangaspero, Felice; Ellison, David W.; Garre, Maria Luisa; Biassoni, Veronica; Grundy, Richard G.; Finlay, Jonathan L.; Dhall, Girish; Raquin, Marie Anne; Grill, Jacques.

In: Journal of Clinical Oncology, Vol. 28, No. 33, 20.11.2010, p. 4961-4968.

Research output: Contribution to journalArticle

Rutkowski, S, Von Hoff, K, Emser, A, Zwiener, I, Pietsch, T, Figarella-Branger, D, Giangaspero, F, Ellison, DW, Garre, ML, Biassoni, V, Grundy, RG, Finlay, JL, Dhall, G, Raquin, MA & Grill, J 2010, 'Survival and prognostic factors of early childhood medulloblastoma: An international meta-analysis', Journal of Clinical Oncology, vol. 28, no. 33, pp. 4961-4968. https://doi.org/10.1200/JCO.2010.30.2299
Rutkowski S, Von Hoff K, Emser A, Zwiener I, Pietsch T, Figarella-Branger D et al. Survival and prognostic factors of early childhood medulloblastoma: An international meta-analysis. Journal of Clinical Oncology. 2010 Nov 20;28(33):4961-4968. https://doi.org/10.1200/JCO.2010.30.2299
Rutkowski, Stefan ; Von Hoff, Katja ; Emser, Angela ; Zwiener, Isabella ; Pietsch, Torsten ; Figarella-Branger, Dominique ; Giangaspero, Felice ; Ellison, David W. ; Garre, Maria Luisa ; Biassoni, Veronica ; Grundy, Richard G. ; Finlay, Jonathan L. ; Dhall, Girish ; Raquin, Marie Anne ; Grill, Jacques. / Survival and prognostic factors of early childhood medulloblastoma : An international meta-analysis. In: Journal of Clinical Oncology. 2010 ; Vol. 28, No. 33. pp. 4961-4968.
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AU - Rutkowski, Stefan

AU - Von Hoff, Katja

AU - Emser, Angela

AU - Zwiener, Isabella

AU - Pietsch, Torsten

AU - Figarella-Branger, Dominique

AU - Giangaspero, Felice

AU - Ellison, David W.

AU - Garre, Maria Luisa

AU - Biassoni, Veronica

AU - Grundy, Richard G.

AU - Finlay, Jonathan L.

AU - Dhall, Girish

AU - Raquin, Marie Anne

AU - Grill, Jacques

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N2 - Purpose: To assess the prognostic role of clinical parameters and histology in early childhood medulloblastoma. Patients and Methods: Clinical and histologic data from 270 children younger than age 5 years diagnosed with medulloblastoma between March 1987 and July 2004 and treated within prospective trials of five national study groups were centrally analyzed. Results: Two hundred sixty children with medulloblastoma and specified histologic subtype were eligible for analysis (median age, 1.89 years; median follow-up, 8.0 years). Rates for 8-year event-free survival (EFS) and overall survival (OS) were 55% and 76%, respectively, in 108 children with desmoplastic/nodular medulloblastoma (DNMB) or medulloblastoma with extensive nodularity (MBEN); 27% and 42%, respectively, in 145 children with classic medulloblastoma (CMB); and 14% and 14%, respectively, in seven children with large-cell/anaplastic (LC/A) medulloblastoma (P <.001). Histology (DNMB/MBEN: hazard ratio [HR], 0.44; 95% CI, 0.31 to 0.64; LC/A medulloblastoma: HR, 2.27; 95% CI, 0.95 to 5.54; P <.001 compared with CMB), incomplete resection and metastases (M0R1: HR, 1.86; 95% CI, 1.29 to 2.80; M+: HR, 2.28; 95% CI, 1.50 to 3.46; P <.001 compared with M0R0), and national group were independent prognostic factors for EFS, and OS. The HRs for OS ranged from 0.14 for localized M0 and DNMB/MBEN to 13.67 for metastatic LC/A medulloblastoma in different national groups. Conclusion: Our results confirm the high frequency of desmoplastic variants of medulloblastomas in early childhood and histopathology as a strong independent prognostic factor. A controlled de-escalation of treatment may be appropriate for young children with DNMB and MBEN in future clinical trials.

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