Surgery for recurrent medulloblastoma: A review

Area of Science:

• Pediatric neuro-oncology
• Pediatric neurosurgery
• Pediatric oncology

Background:

• Medulloblastoma (MB) is the most common pediatric malignant brain tumor.
• Tumor recurrence in MB carries a poor prognosis, and the role of surgery in recurrent cases is unclear.
• This review explores current practices and potential benefits of surgery for recurrent MB.

Purpose of the Study:

• To review the current literature on the role of surgery in managing recurrent medulloblastoma in children.
• To evaluate the potential survival benefits of surgical intervention for recurrent pediatric brain tumors.

Main Methods:

• A literature review of PubMed and Scholar databases from 1990 to 2018.
• Search terms included "medulloblastoma", "recurrence", and "neurosurgical procedures".
• 12 relevant articles were identified from 69 initial results, analyzing 581 cases of recurrent MB.

Main Results:

• Recurrent MB often presents as disseminated craniospinal disease, with only 20% localized to the posterior fossa.
• The overall prognosis for recurrent MB is poor, with a median survival of 18.5 months.
• Surgery at relapse was associated with improved prognosis in cases of solitary posterior fossa recurrence.

Conclusions:

• Recurrent medulloblastoma is frequently fatal, especially after radiotherapy.
• Surgical resection of a focal, single posterior fossa recurrence may offer survival benefits.
• Biopsy is valuable for optimizing targeted therapy and ruling out secondary malignancies.