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

<h4>Background</h4>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.<h4>Patients and methods</h4>This...

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Autores principales:	Jean-Francois Brasme, Jacques Grill, Francois Doz, Brigitte Lacour, Dominique Valteau-Couanet, Stephan Gaillard, Olivier Delalande, Nozar Aghakhani, Stéphanie Puget, Martin Chalumeau
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/130b56eb06a54b97a9888e8c0818487c
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spelling	oai:doaj.org-article:130b56eb06a54b97a9888e8c0818487c2021-11-18T07:23:30ZLong time to diagnosis of medulloblastoma in children is not associated with decreased survival or with worse neurological outcome.1932-620310.1371/journal.pone.0033415https://doaj.org/article/130b56eb06a54b97a9888e8c0818487c2012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22485143/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>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.<h4>Patients and methods</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>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.Jean-Francois BrasmeJacques GrillFrancois DozBrigitte LacourDominique Valteau-CouanetStephan GaillardOlivier DelalandeNozar AghakhaniStéphanie PugetMartin ChalumeauPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 4, p e33415 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jean-Francois Brasme Jacques Grill Francois Doz Brigitte Lacour Dominique Valteau-Couanet Stephan Gaillard Olivier Delalande Nozar Aghakhani Stéphanie Puget Martin Chalumeau Long time to diagnosis of medulloblastoma in children is not associated with decreased survival or with worse neurological outcome.
description	<h4>Background</h4>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.<h4>Patients and methods</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>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.
format	article
author	Jean-Francois Brasme Jacques Grill Francois Doz Brigitte Lacour Dominique Valteau-Couanet Stephan Gaillard Olivier Delalande Nozar Aghakhani Stéphanie Puget Martin Chalumeau
author_facet	Jean-Francois Brasme Jacques Grill Francois Doz Brigitte Lacour Dominique Valteau-Couanet Stephan Gaillard Olivier Delalande Nozar Aghakhani Stéphanie Puget Martin Chalumeau
author_sort	Jean-Francois Brasme
title	Long time to diagnosis of medulloblastoma in children is not associated with decreased survival or with worse neurological outcome.
title_short	Long time to diagnosis of medulloblastoma in children is not associated with decreased survival or with worse neurological outcome.
title_full	Long time to diagnosis of medulloblastoma in children is not associated with decreased survival or with worse neurological outcome.
title_fullStr	Long time to diagnosis of medulloblastoma in children is not associated with decreased survival or with worse neurological outcome.
title_full_unstemmed	Long time to diagnosis of medulloblastoma in children is not associated with decreased survival or with worse neurological outcome.
title_sort	long time to diagnosis of medulloblastoma in children is not associated with decreased survival or with worse neurological outcome.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/130b56eb06a54b97a9888e8c0818487c
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Long time to diagnosis of medulloblastoma in children is not associated with decreased survival or with worse neurological outcome.

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