Introduction: Medulloblastoma is a common brain tumor in children with survival outcomes impacted by both surgical and non-oncological factors. Using Surveillance, Epidemiology, and End Results (SEER) data, this study evaluates several factors for influence on medulloblastoma survival.
Methods: This investigation queried the Surveillance, Epidemiology, and End Results (SEER) for medulloblastoma cases; including 17 cancer registries from 2000-2020. Cases were identified using the International Classification of Diseases (ICD) for Oncology, Third Revision morphology codes (9470/3). Chi-square analysis, Kaplan Meier (KM) curves, cox proportional hazards models, paired t-tests, and analysis of variance (ANOVA) were used to describe survival differences. P-values less than 0.05 were considered significant.
Results: 2,668 total patients were reviewed: Most were less than 19 years old (71%), male (63%), White (54%), and receiving gross total resection (GTR) (62%), radiotherapy (75%), and chemotherapy (80%). KM analysis shows that chemotherapy (p < 0.0001), lower median income (p < 0.0001), white race (p < 0.0001), radiotherapy (p < 0.0001), and GTR (p < 0.0001) were associated with favorable prognosis. Multivariable analysis reveals that Whites have a 29% (p < 0.01) mortality reduction compared to Blacks, local excision has a 41% (p < 0.0001) mortality increase compared to GTR, radiotherapy has a 48% reduction in mortality (p < 0.0001), and income levels over $100,000 have a 54% mortality increase (p < 0.0001) compared to those between $60,000-100,000.
Conclusion : Ethnicity, age, treatment, and income were all relevant factors: Low-income White patients who received chemotherapy, radiotherapy, and GTR had the most favorable prognosis.
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