Medulloblastoma(MB) is one of the most common pediatrics malignant tumors of the central nervous system. Studies in America and Europe have demonstrated significant differences in the prognostic value of medulloblasto...Medulloblastoma(MB) is one of the most common pediatrics malignant tumors of the central nervous system. Studies in America and Europe have demonstrated significant differences in the prognostic value of medulloblastoma extent among molecular subgroups of medulloblastoma. However, studies focusing on the Chinese population are still lacking. A total of 113 patients with medulloblastoma who underwent surgical resection in Huashan Hospital between January 2002 and December 2013 were included in this study. Histological diagnoses were confirmed by 2 or more pathologists. Immunohistochemistry and CTNNB1 exon 3 mutation analysis were used to determine the different subgroups. Complete or incomplete resection was defined based on surgeons' reports and confirmed by postoperative computer tomography(CT). In this study, we included 113 patients with medulloblastoma(13 with WNT subgroup, 18 with SHH subgroup, and 82 with non-SHH/WNT subgroups) to assess their event-free and overall survival. We identified event-free survival and overall survival benefit for complete resection over incomplete resection. We found that for patients with NON-SHH/WNT medulloblastoma, incomplete resection was significantly associated with progression and overall survival compared with complete resection. To our best knowledge, the present study is the first to demonstrate the prognostic value of tumor extent of resection among the molecular subgroups of 113 medulloblastoma in the Chinese population.The prognostic benefit of the increased extent of resection for patients with medulloblastoma is attenuated after the molecular subgroups are taken into account. We still need further study to assess the benefit of surgical resection of small residual portions.展开更多
基金Supported by grant from Shanghai Municipal Science and Technology Commission(No.16410712000)
文摘Medulloblastoma(MB) is one of the most common pediatrics malignant tumors of the central nervous system. Studies in America and Europe have demonstrated significant differences in the prognostic value of medulloblastoma extent among molecular subgroups of medulloblastoma. However, studies focusing on the Chinese population are still lacking. A total of 113 patients with medulloblastoma who underwent surgical resection in Huashan Hospital between January 2002 and December 2013 were included in this study. Histological diagnoses were confirmed by 2 or more pathologists. Immunohistochemistry and CTNNB1 exon 3 mutation analysis were used to determine the different subgroups. Complete or incomplete resection was defined based on surgeons' reports and confirmed by postoperative computer tomography(CT). In this study, we included 113 patients with medulloblastoma(13 with WNT subgroup, 18 with SHH subgroup, and 82 with non-SHH/WNT subgroups) to assess their event-free and overall survival. We identified event-free survival and overall survival benefit for complete resection over incomplete resection. We found that for patients with NON-SHH/WNT medulloblastoma, incomplete resection was significantly associated with progression and overall survival compared with complete resection. To our best knowledge, the present study is the first to demonstrate the prognostic value of tumor extent of resection among the molecular subgroups of 113 medulloblastoma in the Chinese population.The prognostic benefit of the increased extent of resection for patients with medulloblastoma is attenuated after the molecular subgroups are taken into account. We still need further study to assess the benefit of surgical resection of small residual portions.
