Survival of patients with adult medulloblastoma: a population-based study.

BACKGROUND: Adult medulloblastoma accounts for less than 1% of adult intracranial tumors. Previous survival studies have been inconclusive because of small sample sizes and patient ascertainment bias.
METHODS: The Surveillance, Epidemiology, and End Results (SEER) 17 registries database, released April 2007, was used to assess survival rates and prognostic factors in this disease. SEER*Stat was used to calculate observed and relative 2-, 5-, 10-, 15-, and 20-year survival and Cox Proportion Hazard Regression modeling was used to evaluate prognostic variables.
RESULTS: Four hundred fifty-four patients with adult medulloblastoma were diagnosed from 1973-2004 in the 17 regions covered by SEER. The 2-, 5-, and 10-year relative survival rates were 79.9, 64.9, and 52.1%, respectively. The overall median survival was 127 months (10.6 years). The survival of this disease has improved in the last 3 decades. The median survival of those diagnosed <or= 1980 and from 1981-1990 were 39 (3.3 years) and 127 months (10.6 years), respectively, and has not been reached for those diagnosed from 1991-2000 and after 2000. In multivariable regression modeling, diagnoses after the 1980s, age of diagnosis before 20, gross total resection, and radiation were favorable prognostic factors, whereas large cell histology was associated with poor survival.
CONCLUSIONS: This is the largest and most representative survival study to date, but further assessments are needed to evaluate the potential of using molecular genetic markers, together with clinical and histopathologic variables, in predicting survival. This may have to take place in the context of a large consortium.