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Surgical outcome of children with medulloblastoma: a retrospective study of a 405-patient series from Children’s Cancer Hospital Egypt (CCHE-57357)

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A Correction to this article was published on 22 March 2021

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Abstract

Purpose

To analyze the impact of increasing the extent of resection (EOR) on the survival rates and on the surgical outcome of children with medulloblastoma.

Methods

A series of consecutive 405 children operated for medulloblastoma between July 2007 and April 2018 was identified. The details of pre-operative data, surgical interventions, post-operative complications, and survival rates were analyzed.

Results

The Kaplan-Meier (KM) analysis showed no advantage of gross total resection (GTR) over near and subtotal resection regarding over all (OS) (p=0.557) and progression free survival (PFS) (p=0.146). In the same time, increasing the EOR was not associated with higher morbidity. Tumor dissemination at onset correlated to worse OS (KM: p=0.003, OR 1.999, 95% CI: 1.242–3.127; p = 0.004) and PFS (KM: p<0.001, Cox: OR 2.171, 95% CI: 1.406–3.353; p<0.001). OS was significantly affected in patients < 3 years old (KM: p=0.011, OR 2.036, 95% CI: 1.229–3.374; p = 0.006), while PFS was worse among patients who had pre-op seizures (KM: p=0.036, Cox: OR 2.852, 95% CI: 1.046–7.773; p=0.041) or post-op pseudomeningocele (KM: p=0.021, Cox: OR 2.311, 95% CI: 1.123–4.754; p=0.023).

Conclusions

Although surgical excision of medulloblastoma is the standard of care, there was no significant benefit for GTR over near or subtotal resection on the OS or PFS rates that are mainly influenced by the patient’s age and tumor dissemination. However, GTR should be targeted, as it is not associated with increased incidence of mutism or other surgery-related complications.

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Correspondence to Mohamed A. El Beltagy.

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The original online version of this article was revised: The correction in author affiliation was incorrectly carried out. A mistake regarding one author whose affiliation has been changed for another one. Given in this article is the correct affiliation.

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Enayet, A.E., Nabil, M., Rady, M.R. et al. Surgical outcome of children with medulloblastoma: a retrospective study of a 405-patient series from Children’s Cancer Hospital Egypt (CCHE-57357). Childs Nerv Syst 37, 1931–1940 (2021). https://doi.org/10.1007/s00381-021-05082-2

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