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[Relapse modalities in medulloblastoma]

C Di Rocco1, A Iannelli, A Tancredi

  • 1Sezione di Neurochirurgia Infantile, Istituto di Neurochirurgia, Università Cattolica del Sacro Cuore di Roma, Italia.

La Pediatria Medica E Chirurgica : Medical and Surgical Pediatrics
|May 1, 1994
PubMed
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Medulloblastoma relapse and progression were studied in 45 pediatric patients. Extensive surgery improved outcomes, but did not prevent metastasis, with nearly 50% achieving long-term survival.

Area of Science:

  • Pediatric Oncology
  • Neuro-oncology
  • Surgical Oncology

Background:

  • Medulloblastoma is a common malignant brain tumor in children.
  • Understanding relapse and progression patterns is crucial for improving treatment outcomes.
  • Treatment strategies have evolved, necessitating evaluation of long-term results.

Purpose of the Study:

  • To evaluate the patterns of relapse and progression in pediatric medulloblastoma patients.
  • To correlate surgical extent with treatment outcomes and survival rates.
  • To assess the role of cerebrospinal fluid shunting systems in metastasis.

Main Methods:

  • Retrospective analysis of 45 pediatric medulloblastoma patients treated between 1981-1991.
  • Classification of patients based on surgical tumor removal: total, subtotal, and partial.

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  • Evaluation of treatment modalities including surgery, radio-chemotherapy, and irradiation.

    • Main Results:

    • Nearly 50% of patients achieved long-term survival or apparent recovery.
    • Total or subtotal surgical tumor removal was associated with higher rates of disease-free survival.
    • Local relapse was more frequent after partial surgical resection (44.4%) compared to total (12%) or subtotal (27%) resection.
    • Metastasis along the cerebrospinal axis occurred in 1/5-1/6 of patients, irrespective of surgical group.
    • Cerebrospinal fluid shunting systems did not appear to cause extraneural metastases.

    Conclusions:

    • Extensive surgical resection is associated with improved outcomes in pediatric medulloblastoma.
    • While extensive surgery reduces local recurrence, it does not eliminate the risk of distant metastasis.
    • Long-term survival rates approaching 50% are achievable with current treatment paradigms.