Long time to diagnosis of medulloblastoma in children is not associated with decreased survival or with worse neurological outcome. - Cancéropôle du Grand Est Accéder directement au contenu
Article Dans Une Revue PLoS ONE Année : 2012

Long time to diagnosis of medulloblastoma in children is not associated with decreased survival or with worse neurological outcome.

Résumé

BACKGROUND: The long time to diagnosis of medulloblastoma, one of the most frequent brain tumors in children, is the source of painful remorse and sometimes lawsuits. We analyzed its consequences for tumor stage, survival, and sequelae. PATIENTS AND METHODS: This retrospective population-based cohort study included all cases of pediatric medulloblastoma from a region of France between 1990 and 2005. We collected the demographic, clinical, and tumor data and analyzed the relations between the interval from symptom onset until diagnosis, initial disease stage, survival, and neuropsychological and neurological outcome. RESULTS: The median interval from symptom onset until diagnosis for the 166 cases was 65 days (interquartile range 31-121, range 3-457). A long interval (defined as longer than the median) was associated with a lower frequency of metastasis in the univariate and multivariate analyses and with a larger tumor volume, desmoplastic histology, and longer survival in the univariate analysis, but not after adjustment for confounding factors. The time to diagnosis was significantly associated with IQ score among survivors. No significant relation was found between the time to diagnosis and neurological disability. In the 62 patients with metastases, a long prediagnosis interval was associated with a higher T stage, infiltration of the fourth ventricle floor, and incomplete surgical resection; it nonetheless did not influence survival significantly in this subgroup. CONCLUSIONS: We found complex and often inverse relations between time to diagnosis of medulloblastoma in children and initial severity factors, survival, and neuropsychological and neurological outcome. This interval appears due more to the nature of the tumor and its progression than to parental or medical factors. These conclusions should be taken into account in the information provided to parents and in expert assessments produced for malpractice claims.
Fichier principal
Vignette du fichier
journal.pone.0033415.pdf (422.13 Ko) Télécharger le fichier
Origine : Fichiers éditeurs autorisés sur une archive ouverte
Loading...

Dates et versions

inserm-00709377 , version 1 (18-06-2012)

Identifiants

Citer

Jean-Francois Brasme, Jacques Grill, Francois Doz, Brigitte Lacour, Dominique Valteau-Couanet, et al.. Long time to diagnosis of medulloblastoma in children is not associated with decreased survival or with worse neurological outcome.. PLoS ONE, 2012, 7 (4), pp.e33415. ⟨10.1371/journal.pone.0033415⟩. ⟨inserm-00709377⟩
412 Consultations
152 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More