PTPS-19SURVIVAL AND PROGNOSTIC FACTORS IN CHILDREN WITH POSTERIOR FOSSA TUMORS ADMITTED AT THE PHILIPPINE CHILDREN'S MEDICAL CENTER FROM 2004 TO 2013

Abstract

BACKGROUND: Childhood brain tumors are the most common solid neoplasm and the leading cause of cancer-related morbidity and mortality in children. OBJECTIVES: To determine which patient and tumor characteristics are predictive of good outcome in patients with posterior fossa tumors. DESIGN: Analytical retrospective, cross sectional study. SETTING: Tertiary level hospital. PATIENTS: Total of 85 charts of children with posterior fossa tumors admitted at PCMC from 2004 to 2013 were reviewed. MAIN OUTCOME MEASURE(S): Patient and tumor characteristics were determined and analyzed using univariate analysis. Age, extent of tumor resection, and tumor histology were analyzed if predictive of poor outcome. One-year and 3-year overall survival probability were analyzed using the Kaplan-Meier estimation method. Mantel-Cox Log-Rank Overall Comparisons was used to identify prognostic variables for over-all survival. RESULTS: Medulloblastoma is the most common tumor at 62%, pilocytic astrocytoma 23% and ependymoma 11%. Majority belongs to the 36months and older age group with male predominance at 1.36:1. Most common signs and symptoms were headache, vomiting and ataxia. The 1-year and 3-year overall survival probability are 61% and 41%, respectively. Univariate analysis showed that clinical outcome was significantly correlated with gender (female associated with good clinical outcome, p = 0.022) and histologic tumor types (medulloblastoma associated with poor outcome; pilocytic astrocytoma with good outcome, p = 0.012). Gender and histologic tumor types and brainstem involvement were identified as significant factors for 1- and 3-year overall survival (p = 0.049, p = 0.008, and p = 0.029). CONCLUSION: Gender and histologic type of tumors are significant prognostic factors for both the clinical outcome and overall 1-year and 3-year survival probability. Brainstem involvement is a significant prognostic variable for overall survival. One- and three-year overall survival rates are 61 % and 41%, respectively. The need to formulate an institutional tumor guideline to ensure standard treatment and follow-up of these patients are necessary.