{"doi":"10.1093/noajnl/vdad032","title":"Characterization of recurrence patterns and outcomes of medulloblastoma in adults: The University of Texas MD Anderson Cancer Center experience","abstract":"Abstract Background Medulloblastoma in adults is rare and treatment decisions are largely driven from pediatric literature. We sought to characterize recurrent medulloblastoma in adults. Methods From a single-institution dataset of 200 adult patients diagnosed with medulloblastoma during 1978–2017, those with recurrence were analyzed for clinical features, treatment, and outcome. Results Of the 200 patients, 82 (41%) with median age of 29 years (18–59) had recurrence after a median follow-up time of 8.4 years (95% CI = 7.1, 10.3). Of these, 30 (37%) were standard-risk, 31 (38%) were high-risk, and 21 (26%) had unknown-risk diseases at the time of initial diagnosis. Forty-eight (58%) presented with recurrence outside the posterior fossa, of whom 35 (43%) had distant recurrence only. Median Progression-free survival (PFS) and OS from initial surgery were 33.5 and 62.4 months, respectively. Neither PFS nor OS from initial diagnosis differed between the standard-risk and high-risk groups in those who experience recurrence (P = .505 and .463, respectively). Median OS from first recurrence was 20.3 months, also with no difference between the standard-risk and high-risk groups (P = .518). Recurrences were treated with combinations of re-resection (20 patients; 25%), systemic chemotherapy (61 patients; 76%), radiation (29 patients; 36%), stem cell transplant (6 patients; 8%), and intrathecal chemotherapy (4 patients; 5%). Patients who received radiation at recurrence had better OS (32.9 months) than those who did not (19.2 months) (P = .034). Conclusions Recurrent medulloblastoma in adults has a poor prognosis irrespective of initial risk stratification. Recurrence commonly arises outside the posterior fossa years after initial diagnosis.","journal":"Neuro-Oncology Advances","year":2023,"id":357762,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":12,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.5974,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":748060,"name":"Max Mastall","orcid":"0000-0002-0571-9423","position":1,"is_corresponding":false},{"id":288243,"name":"Heather Lin","orcid":"0000-0002-1779-7007","position":2,"is_corresponding":false},{"id":236013,"name":"Kenneth R. Hess","orcid":"0000-0003-1377-6070","position":3,"is_corresponding":false},{"id":268557,"name":"Ying Yuan","orcid":"0000-0003-3163-480X","position":4,"is_corresponding":false},{"id":748061,"name":"Manuela Martín-Bejarano García","orcid":"0000-0003-2719-0687","position":5,"is_corresponding":false},{"id":226431,"name":"Gregory N. Fuller","orcid":"0000-0001-9447-2647","position":6,"is_corresponding":false},{"id":748888,"name":"Kristin D Alfaro","orcid":null,"position":7,"is_corresponding":false},{"id":748062,"name":"Maria Gule-Monroe","orcid":"0000-0002-4418-3705","position":8,"is_corresponding":false},{"id":14371,"name":"Jason T. Huse","orcid":"0000-0003-4514-0640","position":9,"is_corresponding":false},{"id":382773,"name":"Soumen Khatua","orcid":"0000-0001-6416-650X","position":10,"is_corresponding":false},{"id":271512,"name":"Ganesh Rao","orcid":"0000-0003-3609-3491","position":11,"is_corresponding":false},{"id":249354,"name":"David I. Sandberg","orcid":"0000-0002-0245-6461","position":12,"is_corresponding":false},{"id":273500,"name":"Jeffrey S. Wefel","orcid":"0000-0003-3584-023X","position":13,"is_corresponding":false},{"id":423551,"name":"D.N. Yeboa","orcid":"0000-0002-2901-7477","position":14,"is_corresponding":false},{"id":288903,"name":"Arnold C. Paulino","orcid":"0000-0002-0269-3045","position":15,"is_corresponding":false},{"id":423550,"name":"Susan L. McGovern","orcid":"0000-0002-5286-0649","position":16,"is_corresponding":false},{"id":344490,"name":"Wafik Zaky","orcid":"0000-0002-7079-8105","position":17,"is_corresponding":false},{"id":439996,"name":"Anita Mahajan","orcid":"0000-0001-7609-4451","position":18,"is_corresponding":false},{"id":401727,"name":"Dima Suki","orcid":"0000-0002-0715-557X","position":19,"is_corresponding":false},{"id":307377,"name":"Shiao‐Pei Weathers","orcid":"0000-0002-0405-102X","position":20,"is_corresponding":false},{"id":334663,"name":"Rebecca A. Harrison","orcid":"0000-0002-5689-8492","position":21,"is_corresponding":false},{"id":238094,"name":"John de Groot","orcid":"0000-0003-1454-6461","position":22,"is_corresponding":false},{"id":225612,"name":"Vinay K. Puduvalli","orcid":"0000-0001-8396-9500","position":23,"is_corresponding":false},{"id":423237,"name":"Marta Peñas-Prado","orcid":null,"position":24,"is_corresponding":false},{"id":401726,"name":"Nazanin Majd","orcid":"0000-0001-6451-544X","position":25,"is_corresponding":false},{"id":1107541,"name":"Timothy A. 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