Comparing children and adults with medulloblastoma: a SEER based analysis.

Qian Li,Lihua Wang,Yuze Cao,Zhenguo Dai

doi:10.18632/oncotarget.23773

Abstract

Medulloblastoma (MB) is a brain malignancy, which commonly occurs in children, but is rare in adults. The Surveillance, Epidemiology, and End Results (SEER) database was used to compare survival, clinical features, and prognostic factors of children and adults with MB from 1992 to 2013. Overall survival estimates were compared using the Kaplan–Meier method, and Cox Proportion Hazard Regression modeling was used to evaluate prognostic variables. We identified 616 children (63.8%) and 349 adults (36.2%) with diagnosis of MB. The estimated survival rates for children diagnosed with MB for 2, 5, and 10 years were 85.6%, 75.5%, and 67.9%, respectively; the corresponding estimates for adults were 84.9%, 74.2%, and 67.3%. Radiotherapy was the only identical prognostic factor observed in the two groups. Children MB patients were more likely to experience distal metastases that was associated with increased hazard of mortality, and be diagnosed after 2003. Among adult MB patients, gross total resection (GTR) was a favorable prognostic factor, while large cell/anaplastic (LC/A) histology was correlated with decreased survival. Our analysis highlighted that both groups had similar overall survival time, but the prognostic factors were not comparable, except radiotherapy which was associated with better survival.

Highlights

Medulloblastoma (MB) is a highly malignant neuroectodermal tumors, that belongs to high-grade glioma (HGG) and was categorized into WHO grade IV tumours of the Central Nervous System (CNS) [1]
Radiotherapy was the only identical prognostic factor observed in the two groups
MB commonly occurs among children, accounting for approximately 30% of pediatric CNS neoplasms; it is a rare disease among adults, with an annual incidence rate of 0.05 per 100,000 per year, which is fewer than 3% of all the primary neoplasms of the CNS [2, 3]

Summary

Introduction

Medulloblastoma (MB) is a highly malignant neuroectodermal tumors, that belongs to high-grade glioma (HGG) and was categorized into WHO grade IV tumours of the Central Nervous System (CNS) [1]. Controversy remains regarding the survival of MB between children and adults patients, some data suggests that adults fare better than children [4]. K et al reported that children and adults with MB do not differ with respect to overall survival, yet patients who are 3 years old or less fare significantly worse [5]. Rose Lai et al suggested that the survival of children, especially older than 3 years of age, may be better than adults [6]. There has been no research that directly compare and evaluate the overall survival between children (4–19 years) with those of adults (≥ 20 years)

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