A review of clinical and histological features of Spanish paediatric medulloblastomas during the last 21 years

Purpose: To find any feature of prognostic significance among the clinical and histological characteristics of paediatric patients diagnosed with medulloblastoma (MB). Materials and methods: Clinical charts and paraffin blocks of 79 paediatric patients from nine Spanish institutions diagnosed with MB between 1980 and 2001 were reviewed retrospectively. Included clinical and histological characteristics were age, sex, duration of symptoms, physical signs on admission, tumour location, T and M stages of Chang classification, hydrocephalus, cerebrospinal fluid shunt, surgical resection, complications after surgery, MB subtype, desmoplasia, nodularity, fibrilar pattern, nuclear pleomorphism, necrosis grade, proliferation index and intra-tumoural vascularity. Overall and event-free survival (EFS) univariate and multivariate analyses were assessed. Results: Type of surgery and necrosis grade appeared to be independent prognostic variables in overall and EFSs. Although nuclear pleomorphism and intra-tumoural vascularity showed a marginally statistical effect on overall survival (OS), both had a significant influence on EFS. Conclusions: We have confirmed surgical resection and added necrosis grade as independent prognostic factors in terms of OS for children diagnosed with MB.