Kombogiorgas, Dimitrios (2010)
M.Phil. thesis, University of Birmingham.
Aim: To study if the amount of residual medulloblastoma correlates with improved survival. Material and Methods: Tumour volumes were measured on preoperative and immediate postoperative MR scans of 37 children operated on for medulloblastoma between 1999 and 2006. The residuum ratio (post-/ preoperative tumour volume) was calculated and correlated to mortality and actuarial survival. Results: Mean preoperative volume was 32 cm³ (range: 4.43-71.99 cm³). Mean postoperative volume was 3.3 cm³ (range: 0- 23.3 cm³). Mean residuum ratio was 10.7% (range: 0-74%); 28 (75.7%) patients had ≤15% residuum. At mean follow-up of 45 months (range: 6-117), 15 (40.5%) patients had died. Using either the presence of any residual tumour or a limit of 15% residuum ratio, there was no statistically significant difference in mortality or actuarial 5-year survival (p: 0.27, log rank). Also, the difference in 5-year survival of patients with a residual tumour > and >1.5 cm³ was not statistically significant (p= 0.367). Conclusions: While there is a trend for patients with less residual medulloblastoma volume to have better outcome than those with more residual medulloblastoma volume, the number of the patients of this pilot study was not large enough to reach a conclusion and a larger study is required.
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