Analysis of prognostic factors and survival status of children with medulloblastoma
10.3760/cma.j.issn.2095-428X.2019.24.011
- VernacularTitle: 儿童髓母细胞瘤的预后因素和生存分析
- Author:
Shuxu DU
1
;
Miao LI
;
Jin ZHANG
;
Siqi REN
;
Yan LIU
;
Wenchao GAO
;
Shuting LI
;
Jingjing LIU
;
Xiaojun GONG
;
Yanling SUN
;
Wanshui WU
;
Liming SUN
Author Information
1. Department of Pediatrics, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
- Publication Type:Journal Article
- Keywords:
Child;
Medulloblastoma;
Prognosis;
Survival
- From:
Chinese Journal of Applied Clinical Pediatrics
2019;34(24):1886-1890
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the prognostic factors and survival status of children with medulloblastoma (MB) by using retrospective analysis.
Methods:From February 2011 to December 2017, 224 children with newly-diagnosed MB were enrolled in this study, which was carried out at Department of Pediatrics, Beijing Shijitan Hospital, Capital Medical University.The overall survival (OS) rate and progression-free survival (PFS) rate were calcula-ted by using Kaplan-Meier method, the difference between 2 groups was tested by Log-rank method, and prognostic factors were analyzed by COX regression.
Results:Until December 30, 2018, the median survival time of all these 224 children was 4.1 years, the survival rate was 74.6%, complete response (CR) rate was 60.3%, and the relapse rate was 1.7%. The 5-year PFS rate and 5- year OS rate of all patients were (58.2±3.6)% and (72.5±3.3)%, respectively. Survival rates of children in the high-risk group, with metastatic disease, aged <3 years, and with positive tumor cells in the cerebrospinal fluid(CSF) were very low. The 5-year OS rates were (54.8±5.3)%, (57.7±5.9)%, (41.6±8.7)%, and (53.0±7.3)%, respectively.Compared to others, the children with MB large-cell/anaplastic histology [5-year OS rate was (35.3±13.6)%] and MB group 3 subtype [3-year OS rate was (25.0±13.0)%] lived a miserable life.Meanwhile, the children in the stand-risk group, without metastatic disease, no large-cell/anaplastic histology, age older than 3 years, and with tumor cell negative in CSF, lived a better life. The 5-year OS rates were (87.5±3.5)%, (80.3±3.7)%, (70.6±5.5)%, (78.3±3.3)%, and (78.4±3.5)%, respectively, and all of them were over 70.0%. No WNT tumors progressed or relapsed, and 5- year OS rate was 100.0%. The survival status of SHH subgroup was inferior to that of group 4 subtype[(64.8±5.8)% vs.(83.5±3.8)%, χ2=5.417, P=0.015]. With COX analysis, age and tumor cells in CSF at the time of diagnosis were independent risk factors for OS and PFS of MB (PFS: Wald=8.485, P=0.004; Wald=11.702, P=0.001; OS: Wald=16.274, P=0.000; Wald=7.191, P=0.007).
Conclusions:Survival of children with MB more than 3 years old has been reached a perfectly high level.Age and tumor cells in CSF are independent risk factors for the OS and PFS. However, the prognosis of large-cell/anaplastic histology, malignancy cell positive in CSF, group 3 and children under 3 years old, is still poor, and intensive treatment is needed urgently for those patients.
