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Children With Medulloblastoma: Surgical Outcomes and Survival Challenges
Armando Francisco Perez Castell1, Jorge de la Salud Rodríguez Rodríguez2, Elizabeth Meza Mata3
1Neurosurgery and Spine Surgery, Star Médica/Universidad Autónoma de Chihuahua, Chihuahua, MEX.
Insights
Pediatric medulloblastoma survival is influenced by surgical resection extent, tumor location, and histology. Total resection and adjuvant therapy are crucial for improving outcomes in these young patients.
Area of Science:
- Pediatric Oncology
- Neuro-oncology
- Surgical Oncology
Background:
- Medulloblastoma is a common and aggressive pediatric brain tumor.
- Despite multimodal treatments, significant morbidity and mortality persist.
- Understanding prognostic factors is vital for improving patient outcomes.
Purpose of the Study:
- To analyze clinical features of pediatric medulloblastoma.
- To identify prognostic factors affecting overall survival (OS).
- To evaluate outcomes following surgical resection.
Main Methods:
- Retrospective cohort study of 24 pediatric patients (2018-2022).
- Analysis of demographic, radiologic, histopathologic, and treatment data.
- Kaplan-Meier method used for OS and prognostic factor assessment.
Main Results:
- Median OS was 32.28 months; 20-month OS rate was 57.2%.
- Total resection significantly improved survival outcomes.
- Tumor location (cerebellar vermis) and histological subtype (desmoplastic) were key prognostic indicators.
Conclusions:
- Medulloblastoma prognosis varies based on tumor and treatment factors.
- Surgical resection followed by adjuvant therapy is critical for management.
- Further research into optimizing treatment strategies is warranted.
Abstract:
Background Medulloblastoma is one of the most common malignant pediatric brain tumors and remains associated with significant morbidity and mortality despite multimodal treatment strategies. Objective This study aimed to evaluate the clinical characteristics and prognostic factors influencing overall survival in pediatric patients diagnosed with medulloblastoma. Methods This retrospective cohort study analyzed pediatric patients diagnosed with medulloblastoma who underwent surgical resection between 2018 and 2022. Demographic, radiologic, histopathologic, and therapeutic variables were collected. OS and associated prognostic factors were assessed using the Kaplan-Meier method. Results A total of 24 patients were included, with a mean age of 7.83 years; 66.7% were male. Headache was the most frequent presenting symptom (41.7%). Tumors were most commonly located in the cerebellar vermis (33.3%), and the desmoplastic variant was the predominant histological subtype (54%). Homogeneous contrast enhancement was observed in 62% of cases. Subtotal resection was performed in 79.2% of patients. Three patients were lost to follow-up. Among the remaining 21 patients, 13 died during the study period. Median overall survival was 32.28 months, with a 20-month overall survival rate of 57.2%. Total resection was associated with improved survival outcomes. Tumor location and histological subtype also influenced prognosis. Conclusion Medulloblastoma continues to demonstrate variable survival outcomes depending on tumor- and treatment-related factors. Surgical resection combined with adjuvant therapy remains essential in the management of pediatric patients with medulloblastoma.
