ISSN:
0942-0940
Schlagwort(e):
Medulloblastoma
;
PNET-PF
;
grading
;
prognosis
Quelle:
Springer Online Journal Archives 1860-2000
Thema:
Medizin
Notizen:
Summary Although recently survival of some medulloblastoma patients increased remarcably, it remains a serious diagnosis in others. In order to predict the postoperative prognosis in patients treated for medulloblastoma, a new staging, scoring and grading system was developed. Sixty-six patients operated on microsurgically between 1975 and 1990 at a single neurosurgical center were fully followed-up. No patient was excluded due to a poor postoperative course. Completion of commonly used radiotherapy protocols was attempted in all patients. Survival of patients was evaluated by the Kaplan-Meier method. The following 5 parameters were selected to define subgroups: patients' age, tumour location and histology, degree of resection and presence or absence of metastases. Patients older than 10 years had a better prognosis than individuals aged 10 or less (p〈0.01), patients with lateral tumours had a better prognosis than patients with midline tumours with brain stem infiltration (p〈0.05), patients with complete tumour resection had a more favourable prognosis than individuals with subtotal (p〈0.01) or partial resection (p〈0.001), patients without metastases at the time of diagnosis had a better prognosis than individuals without such evidence (p〈0.001), patients with the desmoplastic tumour variant had a better prognosis than patients with classical tumour histology (p〈0.01). According to the prognosis of a distinct subgroup, scoring points were distributed which correlated with the degree of inter-subgroup significances. The sum of a single patient's scoring points was called the total score. Based on this score, three groups of prognosis were distinguished. The good prognosis group (n=29) showed a significantly better survival (p〈0.05) than the moderate prognosis group (n=26), whereas the moderate prognosis group had a significantly better survival (p〈0.05) than the poor prognosis group (n=11). A Kaplan-Meier survival rate of 62% was found in patients of the good prognosis group, a rate of 22% in the moderate prognosis group, and a rate of 0% in the poor prognosis group. It is concluded that this new staging, scoring and grading system is a simple and recommendable prognostic system for all patients treated surgically for medulloblastoma.
Materialart:
Digitale Medien
URL:
http://dx.doi.org/10.1007/BF01404849
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