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Published on: January 12, 2019
Prognostic value of temporal muscle thickness in pediatric medulloblastoma patients aged 3-12 years
Xu An1,2, Junhua Wang3, Jingzhe Yuan1
1Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, No. 119 Nansihuanxilu, Fengtai District, Beijing, China.
Purpose:
This retrospective, multicenter cohort study aimed to investigate the prognostic significance of temporal muscle thickness (TMT) in medulloblastoma (MB) patients.
Methods:
Preoperative cranial MRI was used to measure TMT. Patients were divided into training and test cohorts. An optimal TMT cutoff for progression-free survival (PFS) and overall survival (OS) was established.
Results:
Among the 303 enrolled MB patients, TMT was found to be associated with prognosis in the 230 patients aged 3-12 years. TMT demonstrated positive correlations with age and body mass index, while inverse associations were observed with the presence of hydrocephalus and metastasis. A TMT cutoff value of 6.115 mm was established in the training cohort, which served as a significant threshold for both PFS and OS. The 5-year PFS rates were (38.0 ± 11.5) % (low mean-TMT group) versus (88.3 ± 3.2) % (high mean-TMT group), and OS rates were (57.2 ± 8.7) % versus (96.5 ± 1.7) %, respectively. The multivariate Cox regression revealed significantly better PFS (hazard ratio (HR) = 0.165; 95% confidence interval (CI): 0.064-0.427; P < 0.001) and OS (HR = 0.064; 95% CI: 0.020-0.207; P < 0.001) in patients above versus below this cutoff. These findings were validated in test cohort and two independent validation cohorts.
Conclusion:
MRI-measured TMT is a potential prognostic indicator for MB patients aged 3-12 years, and may help guide risk stratification and treatment planning. To validate its clinical applicability, large-sample prospective researches remain essential.
