Histopathologic grading of adult medulloblastomas

Fausto J. Rodriguez, Charles Eberhart, Brian Patrick O'Neill, Jeff Slezak, Peter C. Burger, Patricia Goldthwaite, Wenting Wu, Caterina Giannini

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

BACKGROUND. Histopathologic evaluation of the degree and extent of anaplasia is a useful prognostic parameter in pediatric medulloblastomas. Whether the same applies to adult medulloblastomas is not known. METHODS. The study included 74 adult patients with histologically confirmed medulloblastomas and retrospectively reassessed 67 cases with available slides for the presence of nodularity, collagen deposition (desmoplasia without nodules), and degree and extent of anaplasia. RESULTS. Patients included 43 men and 31 women with the following age distribution: 18-40 years (84%); 41-50 years (9%); and 51-70 years (7%). At last follow-up, 56 patients were alive with a mean follow-up of 6.3 years (range, 0.1-20.8 years). A variety of treatments were employed during the study period, including postoperative radiation (85%) and chemotherapy (27%). Precise treatment modalities were unknown in 12% of patients. Anaplasia was absent (34%), mild (34%), moderate (27%), or severe (5%). Severe anaplasia was diffuse in 2 cases and focal in 1, although in the latter cases severe anaplasia was diffusely present at the time of disease recurrence. Male sex was associated with decreased 10-year recurrence-free survival (40% vs 66%; P = .021) and overall survival (38% vs 68%; P = .005). Severe anaplasia at first resection was found to be an independent predictor of decreased recurrence-free survival (P = .005) and overall survival (P = .015). CONCLUSIONS. The incidence of severe anaplasia in adult medulloblastomas is lower than in the pediatric population. Male sex and the presence of severe anaplasia at the time of first resection are predictors of decreased recurrence-free and overall survival. However, the significance of severe anaplasia should be regarded with caution based on the small number of tumors with this feature in the current study.

Original languageEnglish (US)
Pages (from-to)2557-2565
Number of pages9
JournalCancer
Volume109
Issue number12
DOIs
StatePublished - Jun 15 2007

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Anaplasia
Medulloblastoma
Survival
Recurrence
Pediatrics
Age Distribution
Postoperative Period
Collagen
Radiation

Keywords

  • Adult medulloblastomas
  • Anaplasia
  • Brain tumors
  • Histopathologic grading
  • Medulloblastoma

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Rodriguez, F. J., Eberhart, C., O'Neill, B. P., Slezak, J., Burger, P. C., Goldthwaite, P., ... Giannini, C. (2007). Histopathologic grading of adult medulloblastomas. Cancer, 109(12), 2557-2565. https://doi.org/10.1002/cncr.22717

Histopathologic grading of adult medulloblastomas. / Rodriguez, Fausto J.; Eberhart, Charles; O'Neill, Brian Patrick; Slezak, Jeff; Burger, Peter C.; Goldthwaite, Patricia; Wu, Wenting; Giannini, Caterina.

In: Cancer, Vol. 109, No. 12, 15.06.2007, p. 2557-2565.

Research output: Contribution to journalArticle

Rodriguez, FJ, Eberhart, C, O'Neill, BP, Slezak, J, Burger, PC, Goldthwaite, P, Wu, W & Giannini, C 2007, 'Histopathologic grading of adult medulloblastomas', Cancer, vol. 109, no. 12, pp. 2557-2565. https://doi.org/10.1002/cncr.22717
Rodriguez FJ, Eberhart C, O'Neill BP, Slezak J, Burger PC, Goldthwaite P et al. Histopathologic grading of adult medulloblastomas. Cancer. 2007 Jun 15;109(12):2557-2565. https://doi.org/10.1002/cncr.22717
Rodriguez, Fausto J. ; Eberhart, Charles ; O'Neill, Brian Patrick ; Slezak, Jeff ; Burger, Peter C. ; Goldthwaite, Patricia ; Wu, Wenting ; Giannini, Caterina. / Histopathologic grading of adult medulloblastomas. In: Cancer. 2007 ; Vol. 109, No. 12. pp. 2557-2565.
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abstract = "BACKGROUND. Histopathologic evaluation of the degree and extent of anaplasia is a useful prognostic parameter in pediatric medulloblastomas. Whether the same applies to adult medulloblastomas is not known. METHODS. The study included 74 adult patients with histologically confirmed medulloblastomas and retrospectively reassessed 67 cases with available slides for the presence of nodularity, collagen deposition (desmoplasia without nodules), and degree and extent of anaplasia. RESULTS. Patients included 43 men and 31 women with the following age distribution: 18-40 years (84{\%}); 41-50 years (9{\%}); and 51-70 years (7{\%}). At last follow-up, 56 patients were alive with a mean follow-up of 6.3 years (range, 0.1-20.8 years). A variety of treatments were employed during the study period, including postoperative radiation (85{\%}) and chemotherapy (27{\%}). Precise treatment modalities were unknown in 12{\%} of patients. Anaplasia was absent (34{\%}), mild (34{\%}), moderate (27{\%}), or severe (5{\%}). Severe anaplasia was diffuse in 2 cases and focal in 1, although in the latter cases severe anaplasia was diffusely present at the time of disease recurrence. Male sex was associated with decreased 10-year recurrence-free survival (40{\%} vs 66{\%}; P = .021) and overall survival (38{\%} vs 68{\%}; P = .005). Severe anaplasia at first resection was found to be an independent predictor of decreased recurrence-free survival (P = .005) and overall survival (P = .015). CONCLUSIONS. The incidence of severe anaplasia in adult medulloblastomas is lower than in the pediatric population. Male sex and the presence of severe anaplasia at the time of first resection are predictors of decreased recurrence-free and overall survival. However, the significance of severe anaplasia should be regarded with caution based on the small number of tumors with this feature in the current study.",
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AU - Rodriguez, Fausto J.

AU - Eberhart, Charles

AU - O'Neill, Brian Patrick

AU - Slezak, Jeff

AU - Burger, Peter C.

AU - Goldthwaite, Patricia

AU - Wu, Wenting

AU - Giannini, Caterina

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N2 - BACKGROUND. Histopathologic evaluation of the degree and extent of anaplasia is a useful prognostic parameter in pediatric medulloblastomas. Whether the same applies to adult medulloblastomas is not known. METHODS. The study included 74 adult patients with histologically confirmed medulloblastomas and retrospectively reassessed 67 cases with available slides for the presence of nodularity, collagen deposition (desmoplasia without nodules), and degree and extent of anaplasia. RESULTS. Patients included 43 men and 31 women with the following age distribution: 18-40 years (84%); 41-50 years (9%); and 51-70 years (7%). At last follow-up, 56 patients were alive with a mean follow-up of 6.3 years (range, 0.1-20.8 years). A variety of treatments were employed during the study period, including postoperative radiation (85%) and chemotherapy (27%). Precise treatment modalities were unknown in 12% of patients. Anaplasia was absent (34%), mild (34%), moderate (27%), or severe (5%). Severe anaplasia was diffuse in 2 cases and focal in 1, although in the latter cases severe anaplasia was diffusely present at the time of disease recurrence. Male sex was associated with decreased 10-year recurrence-free survival (40% vs 66%; P = .021) and overall survival (38% vs 68%; P = .005). Severe anaplasia at first resection was found to be an independent predictor of decreased recurrence-free survival (P = .005) and overall survival (P = .015). CONCLUSIONS. The incidence of severe anaplasia in adult medulloblastomas is lower than in the pediatric population. Male sex and the presence of severe anaplasia at the time of first resection are predictors of decreased recurrence-free and overall survival. However, the significance of severe anaplasia should be regarded with caution based on the small number of tumors with this feature in the current study.

AB - BACKGROUND. Histopathologic evaluation of the degree and extent of anaplasia is a useful prognostic parameter in pediatric medulloblastomas. Whether the same applies to adult medulloblastomas is not known. METHODS. The study included 74 adult patients with histologically confirmed medulloblastomas and retrospectively reassessed 67 cases with available slides for the presence of nodularity, collagen deposition (desmoplasia without nodules), and degree and extent of anaplasia. RESULTS. Patients included 43 men and 31 women with the following age distribution: 18-40 years (84%); 41-50 years (9%); and 51-70 years (7%). At last follow-up, 56 patients were alive with a mean follow-up of 6.3 years (range, 0.1-20.8 years). A variety of treatments were employed during the study period, including postoperative radiation (85%) and chemotherapy (27%). Precise treatment modalities were unknown in 12% of patients. Anaplasia was absent (34%), mild (34%), moderate (27%), or severe (5%). Severe anaplasia was diffuse in 2 cases and focal in 1, although in the latter cases severe anaplasia was diffusely present at the time of disease recurrence. Male sex was associated with decreased 10-year recurrence-free survival (40% vs 66%; P = .021) and overall survival (38% vs 68%; P = .005). Severe anaplasia at first resection was found to be an independent predictor of decreased recurrence-free survival (P = .005) and overall survival (P = .015). CONCLUSIONS. The incidence of severe anaplasia in adult medulloblastomas is lower than in the pediatric population. Male sex and the presence of severe anaplasia at the time of first resection are predictors of decreased recurrence-free and overall survival. However, the significance of severe anaplasia should be regarded with caution based on the small number of tumors with this feature in the current study.

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