Materiały źródłowe

• #1 An online calculator using machine learning for predicting survival in pediatric patients with medulloblastoma in: Journal of Neurosurgery: Pediatrics Volume 33 Issue 1 (2023) Journals

  https://thejns.org/pediatrics/view/journals/j-neurosurg-pediatr/33/1/article-p85.xml

  Medulloblastoma is the most common malignant intracranial tumor affecting the pediatric population. Despite advancements in multimodal treatment over the past 2 decades yielding a 5-year survival rate 75%, children who survive often have substantial neurological and cognitive sequelae. […] The concordance index was 0.769 in the training cohort and 0.755 in the validation cohort, denoting clinically useful predictive accuracy. Good agreement between the predicted and observed outcomes was demonstrated by the calibration plots. […] An easy-to-use prognostic calculator for a large cohort of pediatric patients with medulloblastoma was established. Future efforts should focus on improving granularity of population-based registries and externally validating the proposed calculator. […] Our model was consistent with what is known and well established overall regarding treatment of most patients: surgery, radiotherapy, and chemotherapy are all important to increased survival.

• #1 Medulloblastoma: Diagnosis and Treatment – NCI

  https://www.cancer.gov/rare-brain-spine-tumor/tumors/medulloblastoma

  The likely outcome of the disease or chance of recovery is called prognosis. The relative five-year survival rate for medulloblastoma is 80.6 percent. However, many factors can affect prognosis. These include the tumor molecular group, staging, extent of resection, the persons age and health when diagnosed, and how they respond to treatment. If you want to understand your prognosis, talk to your doctor.

• #1 Pathology, diagnostics, and classification of medulloblastoma

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7317787/

  Medulloblastoma (MB) is the most common CNS embryonal tumor. While the overall cure rate is around 70%, patients with high-risk disease continue to have poor outcome and experience long-term morbidity. […] The 5-year overall survival for MB is approximately 75%, however, long-term therapy-related morbidity remains a significant concern. […] The prognostic significance for the large cell and anaplastic variants was initially established in two related cohorts. The relationship between large cell morphology and clinical risk was first established in a cohort of six Pediatric Oncology Group (POG) frontline trials. A more comprehensive grading scheme for anaplasia in MB was later established and applied to an augmented cohort containing seven POG frontline trials by Eberhart and Burger who established a relationship between the large cell variant and severe anaplasia on event-free survival (EFS) and overall survival (OS).

• #1 Medulloblastoma: clinicopathological parameters, risk stratification, and survival analysis of immunohistochemically validated molecular subgroups | Journal of the Egyptian National Cancer Institute | Full Text

  https://jenci.springeropen.com/articles/10.1186/s43046-021-00060-w

  Medulloblastoma classification based on molecular subgroups, together with clinicopathological indicators, mainly histopathological types; accurately risk stratifies MB patients and predicts their survival. […] OS was 77.5% and 50% after 1 and 2 years, while PFS was 65% and 27.5% after 1 and 2 years, respectively. […] Kaplan-Meier curves revealed that both OS and PFS associated significantly with histopathological variants (p value 0.001 and 0.001), molecular subgroups (p value = 0.012 and 0.005), and risk stratification (p value 0.001 and 0.001), respectively. […] MBs of LCA histology exhibited the worst OS and PFS (18.8% and 12.5%, respectively). Among the molecular subgroups, WNT had the best outcome with excellent PFS (100%), and the non-WNT/SHH showed the worst OS (33.3%). […] In conclusion, histopathological types, molecular subgroups (determined by -catenin and GAB1 immunohistochemistry), and risk stratification are important prognosticators, and are associated with overall and progression-free survival of MB patients.

• #1 Risk factors and risk prediction model for recurrence in medulloblastoma – Ai – Translational Pediatrics

  https://tp.amegroups.org/article/view/133603/html

  At present, there is a lack of established treatment protocols for recurrent medulloblastoma. […] The objective of this study is to construct an enhanced risk prediction model for relapse in medulloblastoma by integrating molecular subtyping and straightforward immune markers, such as neutrophil-to-lymphocyte ratio (NLR), into a nomogram. […] The median progression-free survival (PFS) for the entire cohort was determined to be 63.8 months. […] Univariate and multivariate Cox regression analyses were conducted to identify independent prognostic factors that were associated with PFS in patients diagnosed with medulloblastoma. […] These identified factors were then utilized to construct a column chart. […] The nomogram C-index for the predicted PFS in the training and validation cohorts was 0.749 and 0.736, respectively.

• #1 Clinical, Histological, and Molecular Prognostic Factors in Childhood Medulloblastoma: Where Do We Stand?

  https://www.mdpi.com/2075-4418/13/11/1915

  Clinical and histological factors were the initial determinants of prognosis and the main parameters used for patient categorization into standard and high risk. […] However, the development of new molecular techniques has revolutionized the prognostication of MBs, creating new molecular subgroups with distinct clinical features, response to treatment options, and prognosis. […] The most recent edition of CNS tumor classification (CNS 5), from 2021, divided medulloblastomas into “molecularly” and “histologically” defined, denoting the diverse biology of the tumor. […] The main scope of our review is to summarize the evidence concerning clinical, pathological, and molecular factors affecting the prognosis of childhood medulloblastomas. […] The extent of disease is another significant factor that affects the prognosis of childhood MBs and is included in the risk-stratification system.

• #1 Prognostic classification of pediatric medulloblastoma based on chromosome 17p loss, expression of MYCC and MYCN, and Wnt pathway activation

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3266382/

  Diminished survival in age 3 years was more substantial in subgroups with high expression of MYCC, MYCN, or 17p loss but not in other subgroups, indicating that poor survival outcome might be synergistically affected by these 3 factors. […] Here we suggest a more tailored subgrouping system based on expression profiles of chromosome 17p, MYCC, and MYCN, which could provide the basis for a novel risk-stratification strategy in pediatric medulloblastoma. […] Based on the analysis of large combined data from several independent cohorts, we found that chromosome 17p loss and the expression levels of MYCC and MYCN are significant determinants for survival in medulloblastoma. […] Considering these 2 factors simultaneously, we could stratify patients into subgroups with distinct survival. […] The relationship between MYCC(N) and poor prognosis became more prominent after separation of the Wnt group from the medulloblastoma data set by reducing the confounding effect of the Wnt group because patients with high Wnt/-catenin signaling are often linked to good prognosis despite their elevated expression of MYCC and MYCN, which are known downstream targets of Wnt signaling. […] In conclusion, we suggest a more tailored subgrouping system based on expression profiles of chromosome 17p, MYCC, and MYCN, which could ultimately lead to the basis for a new risk-stratification strategy in medulloblastoma.

• #1 Clinical, Histological, and Molecular Prognostic Factors in Childhood Medulloblastoma: Where Do We Stand?

  https://www.mdpi.com/2075-4418/13/11/1915

  Surgical resection comprises an important part of MB treatment plans, and the extent of resection poses a significant prognostic factor. […] The main goal of resection is the removal of the whole extent of the tumor, with gross total resection (GTR) demonstrating a favorable impact on both PFS and OS. […] There are four main histological subtypes of MBs: desmoplastic/nodular (DMN), classic (CMB), MBs with extensive nodularity (MBEN), and large cell/anaplastic (LCA). […] Each of them is characterized by different histological patterns and is associated with distinct molecular and genetic alterations, exhibiting diverse prognosis. […] The poor prognosis of that subtype could be attributed to the association of LCA with high-risk features, as it usually affects patients at a younger age, is diagnosed with metastasis at presentation, and is associated with specific molecular and genetic alternations such as LOH, isochromosome 17q, and MYC-family genes.

• #1

  https://braintumourresearch.org/pages/types-of-brain-tumours-medulloblastoma?srsltid=AfmBOoqNTmMoYW64DkrmE5uvXGp9A1_lGMNnYo7bsZVTMkngzK70mGNo

  Medulloblastoma can be treated with a combination of surgery, radiotherapy, and chemotherapy. […] The likelihood of a complete cure depends on various factors, such as the age and overall health of the patient, the size and location of the tumour, and whether cancer has spread to other parts of the body. With modern treatment methods, the cure rate for medulloblastoma can be as high as 70-80% for children and 50-60% for adults. However, some patients may experience a recurrence of the tumour, which may require further treatment. Early diagnosis and prompt treatment can improve the chances of a successful outcome. […] Survival rates in children with medulloblastoma depend on the patient’s age and if the tumour has spread. If the disease has not spread, survival rates are above 60%, but if it has spread to the spinal cord, the survival rate is reduced. The exact type of medulloblastoma makes a difference to the prognosis. For example, a WNT-activated medulloblastoma is considered relatively low-risk with a better prognosis than those classified as Sonic Hedgehog (SHH) activated, grade 3 or grade 4. For children and adults with a recurrent medulloblastoma (where the tumour grows back quickly despite having treatment to remove it), the prognosis is shorter, with a five-year survival rate of less than 40%. Advances in surgery, radiation, and chemotherapy are contributing to an increase in survival rates, but side effects of treatment can produce long-term challenges for patients, including cognitive difficulties along with psychological and social problems. Longer term support services may be required in order to maximise quality of life.

• #1 Risk factors and risk prediction model for recurrence in medulloblastoma – Ai – Translational Pediatrics

  https://tp.amegroups.org/article/view/133603/html

  In this study, we confirmed that the extent of disease dissemination, age at diagnosis, size of residual lesion after surgery, tumor histopathology, classification as G3, pre-treatment NLR are important prognostic factors for relapse after treatment of medulloblastoma. […] In summary, in the present study, we have developed and validated an nomogram for the prognosis of recurrent medulloblastoma by integrating independent prognostic indicators.

• #1 An online calculator using machine learning for predicting survival in pediatric patients with medulloblastoma in: Journal of Neurosurgery: Pediatrics Volume 33 Issue 1 (2023) Journals

  https://thejns.org/pediatrics/view/journals/j-neurosurg-pediatr/33/1/article-p85.xml

  Higher median household income and urban counties were associated with longer survival time in comparison with lower household income and rural attributes. […] Our model may be a useful adjunct to the current approach, providing a framework for clinicians and patients alike to consider prognosis during treatment planning. […] This study is the first to develop and validate a clinical prognostic calculator for pediatric medulloblastoma, providing an interactive, web-based platform for individualized expected survival. […] In this study, we developed a prognostic tool for predicting survival in pediatric patients with medulloblastoma. Despite having sufficient predictive power and good clinical application value, this model requires further addition of granular data and external validation with a more heterogeneous cohort to become clinically meaningful and useful.

• #1 Pathology, diagnostics, and classification of medulloblastoma

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7317787/

  The overall survival at 3 years for LCA tumors in the SIOP PNET3 study was 67% compared to 81% in children with classic tumors, and the prognostic significance of LCA morphology held up as an independent predictor of risk after multivariate analysis which included known clinical risk factors such as metastatic disease and extent of resection. […] The association of LCA histology with poor outcome probably relates, at least partially, to its close association with other high-risk molecular features. For instance, amplification of MYC and MYCN is more frequent in tumors with LCA histology. Similarly, LCA tumors are also enriched in both the high-risk G3 molecular subtype and SHH tumors with TP53 abnormalities, which are also associated with dismal prognosis. […] The association of LCA histology with clinical risk is largely based on historic cohorts which failed to stratify by molecular group. There is some indication that the LCA morphology maintains its prognostic significance on progression-free survival within molecular subgroup, however, whether anaplasia alone should dictate high-risk disease alone in the absence of other high-risk clinical features such as metastasis remains controversial.

• #1 Clinico-Radiological Outcomes in WNT-Subgroup Medulloblastoma

  https://www.mdpi.com/2075-4418/14/4/358

  Medulloblastoma (MB) comprises four broad molecular subgroups, namely wingless (WNT), sonic hedgehog (SHH), Group 3, and Group 4, respectively, with subgroup-specific developmental origins, unique genetic profiles, distinct clinico-demographic characteristics, and diverse clinical outcomes. […] At a median follow-up of 72 months, Kaplan–Meier estimates of 5-year progression-free survival and overall survival were 87.7% and 91.2%, respectively. […] Traditional high-risk features, large residual tumour (≥1.5 cm²), and leptomeningeal metastases (M+) did not significantly impact upon survival in this molecularly characterized WNT-MB cohort treated with risk-stratified contemporary multimodality therapy. […] The lack of a prognostic impact of conventional high-risk features suggests the need for refined risk stratification and potential deintensification of therapy. […] This retrospective clinical audit confirms excellent survival in WNT-MB patients treated with contemporary multimodality therapy comprising maximal safe resection followed by risk-stratified appropriate radio(chemo)therapy.

• #1

  https://link.springer.com/article/10.1007/s00381-010-1260-5

  Medulloblastoma is the most frequent type of embryonal tumor in the pediatric population, accounting for 2025% of all brain tumors in children. […] In this study, we evaluated the expression of BMI1 and PCGF2, members of family of PcG genes, and their potential target, MYC oncogene, and analyzed their association with demographic and clinical data. […] We found that the higher expression levels of BMI1 and PCGF2 genes were associated with significantly decreased patient survival (p=0.02 and p=0.012, respectively). […] Our analysis showed correlation between BMI1 and PCGF2 genes expression and survival in children with medulloblastoma. […] The survival analysis performed following the group stratification based on the median expression level of each gene revealed an association between higher expression levels of BMI1 and PCGF2 and a significantly decreased patient survival rate (p=0.02 and p=0.012, respectively).

• #1

  https://link.springer.com/article/10.1007/s00381-010-1260-5

  Estimation of outcomes, using the KaplanMeier method, demonstrate a prediction of 5-year survival rates of 35% and 65% for high and low expression levels of the BMI1 gene, respectively, and 37% and 70% for high and low expression levels of the PCGF2 gene, respectively. […] In summary, our analysis suggest that BMI1 and PCGF2 genes, acting as the epigenetic silencers engaged in the self-renewal processes of neoplastic stem cells, could be engaged in medulloblastoma oncogenesis. Higher BMI1 and PCGF2 genes expression levels should be considered as the predictors of poor clinical outcome for children with medulloblastoma.

• #1 Preoperative Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio are Associated with the Prognosis of Group 3 and Group 4 Medulloblastoma | Scientific Reports

  https://www.nature.com/articles/s41598-019-49733-6

  Inflammation and immunoreaction markers were correlated with the survival of patients in many tumors. […] A total 144 MB patients were enrolled in the study. […] Increased preoperative NLR (neutrophil-to-lymphocyte ratio, PFS, P=0.004, OS, P<0.001) and PLR (platelet-to-lymphocyte ratio, PFS, P=0.028, OS, P=0.003) predicted poor prognosis in patients with MB, while preoperative MLR (monocyte-to-lymphocyte ratio), MPV (mean platelet volume), PDW (platelet distribution width), and AGR (albumin-to-globulin ratio) were revealed no predictive value on the prognosis of patients with MB. [...] Furthermore, high preoperative NLR and PLR predicted unfavorable prognosis in childhood MB patients. [...] Multivariate analysis demonstrated preoperative NLR (PFS, P=0.029, OS, P=0.005) and PLR (PFS, P=0.023, OS, P=0.005) were the independent prognostic factors in MB patients.

• #1 Preoperative Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio are Associated with the Prognosis of Group 3 and Group 4 Medulloblastoma | Scientific Reports

  https://www.nature.com/articles/s41598-019-49733-6

  High preoperative NLR was associated with unfavorable OS in Group 3 (P=0.032) and Group 4 (P=0.027) tumors. […] Similarly, increased preoperative PLR predicted poor PFS (P=0.012) and OS (P=0.009) in Group 4 tumors. […] Preoperative NLR and PLR were the potential prognostic markers for MB patients. […] Preoperative NLR and PLR were significantly associated with the survival of Group 3 and Group 4 tumors. […] We found that high preoperative NLR and PLR predicted unfavorable survival in MB patients, while preoperative MLR, MPV, PDW and AGR had no predictive value on the prognosis in MB patients. […] High preoperative NLR predicted unfavorable OS in Group 3 and Group 4 MB and high preoperative PLR was associated with unfavorable PFS and OS in Group 4 MB. […] High preoperative NLR (PFS, P=0.002, OS, P=0.001) and PLR (PFS, P=0.030, OS, P=0.003) predicted worse prognosis in childhood MB patients. […] High preoperative NLR predicted unfavorable OS (P=0.032) in Group 3 MB. […] High preoperative NLR and PLR predict unfavorable survival in Group 3 and Group 4 MB.

• #1 Prognostic classification of pediatric medulloblastoma based on chromosome 17p loss, expression of MYCC and MYCN, and Wnt pathway activation

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3266382/

  Pediatric medulloblastoma is considered a highly heterogeneous disease and a new strategy of risk stratification to optimize therapeutic outcomes is required. […] We analyzed gene expression profiles of 30 primary medulloblastomas and detected strong evidence that poor survival outcome was significantly associated with mRNA expression profiles of 17p loss. […] When patients were stratified into 5 or 7 subgroups based on simultaneous consideration of these 2 factors while defining the Wnt group as independent, obviously different survival expectancies were detected between the subgroups. […] For instance, predicted 5-year survival probabilities ranged from 19% to 81% in the 5 subgroups. […] We also found that age became a significant prognostic marker after adjusting for 17p, MYCC, and MYCN status.

• #1 Clinical, Histological, and Molecular Prognostic Factors in Childhood Medulloblastoma: Where Do We Stand?

  https://www.mdpi.com/2075-4418/13/11/1915

  The latest WHO classification combines all the above histological subtypes into one category, called histologically defined MBs, which are associated with specific molecular pathways, suggesting the need for a multilayered evaluation of specific tumor characteristics. […] Recurrence of MB (relapsed MB, rMB) is considered a serious adverse event of the tumor, which is present in approximately 30% of patients and associated with poor prognosis. […] Recent studies have reported significantly diminished PFS and OS for rMBs (only 5% of patients will remain alive after 5 years), even in the presence of a wide range of therapeutic options, such as re-irradiation, surgery, chemotherapy, and targeted therapies. […] The observation of different treatment outcomes among MB patients, their diversity in histopathological and molecular characteristics, and the presence of different cells of origin, imply the detection of discrete molecular findings at relapse compared to the primary tumor. […] The new era in molecular-based medulloblastoma prognosis and stratification has arrived.

• #1 Deep learning models for predicting the survival of patients with medulloblastoma based on a surveillance, epidemiology, and end results analysis | Scientific Reports

  https://www.nature.com/articles/s41598-024-65367-9

  Medulloblastoma is a malignant neuroepithelial tumor of the central nervous system. Accurate prediction of prognosis is essential for therapeutic decisions in medulloblastoma patients. […] The DeepSurv model outperformed the RSF and classic CoxPH models with C-indexes of 0.751 and 0.763 for the training and test datasets. Additionally, the DeepSurv model showed better accuracy in predicting 1-, 3-, and 5-year survival rates (AUC: 0.7670.793). Therefore, our prediction model based on deep learning algorithms can more accurately predict the survival rate and survival period of medulloblastoma compared to other models. […] Certain prognostic features, such as age at diagnosis, extent of resection, histological subtype, and molecular subgroup classification, have been found to affect survival predictions in individual patients.

• #1 Risk factors and risk prediction model for recurrence in medulloblastoma – Ai – Translational Pediatrics

  https://tp.amegroups.org/article/view/133603/html

  Our study revealed that the NLR prior to treatment serves as an autonomous prognostic determinant for the recurrence or metastasis of medulloblastoma subsequent to treatment. […] By integrating NLR with clinical variables, the utilization of a nomogram demonstrates the capability to anticipate PFS following radiotherapy in medulloblastoma patients. […] This nomogram exhibits potential in facilitating more accurate risk stratification, thereby guiding the implementation of personalized treatment strategies for individuals with medulloblastoma. […] The evaluation of relapse risk in medulloblastoma before initiating treatment holds significant importance in determining the appropriate treatment modalities and intensities. […] The recurrence of medulloblastoma is related not only to the extent of dissemination of the central nervous system disease at the time of diagnosis, the age at the time of diagnosis, the size of the residual lesion after surgery, and the tumor histopathology, but also to the biological/molecular characteristics of the tumor cells and the immune state of the patient.

• #2

  https://link.springer.com/article/10.1007/s00381-010-1260-5

  Medulloblastoma is the most frequent type of embryonal tumor in the pediatric population, accounting for 2025% of all brain tumors in children. […] In this study, we evaluated the expression of BMI1 and PCGF2, members of family of PcG genes, and their potential target, MYC oncogene, and analyzed their association with demographic and clinical data. […] We found that the higher expression levels of BMI1 and PCGF2 genes were associated with significantly decreased patient survival (p=0.02 and p=0.012, respectively). […] Our analysis showed correlation between BMI1 and PCGF2 genes expression and survival in children with medulloblastoma. […] The survival analysis performed following the group stratification based on the median expression level of each gene revealed an association between higher expression levels of BMI1 and PCGF2 and a significantly decreased patient survival rate (p=0.02 and p=0.012, respectively).

• #2 Clinical, Histological, and Molecular Prognostic Factors in Childhood Medulloblastoma: Where Do We Stand?

  https://www.mdpi.com/2075-4418/13/11/1915

  Medulloblastomas, highly aggressive neoplasms of the central nervous system (CNS) that present significant heterogeneity in clinical presentation, disease course, and treatment outcomes, are common in childhood. […] Since 1990, when the estimated event-free survival (EFS) of MBs was 20–50%, and with the application of newer therapeutic techniques, the median overall survival of all subtypes is estimated to be 70%. […] The tumor presents a significant biological heterogeneity, as it has been observed that about 30% of patients will be diagnosed with metastatic disease at presentation, and patients who survive may be diagnosed with subsequent malignancies during their life or develop treatment-related neurocognitive, endocrinological, or development disorders, highlighting the need for risk stratification of patients with MB.

• #2 Clinical, Histological, and Molecular Prognostic Factors in Childhood Medulloblastoma: Where Do We Stand?

  https://www.mdpi.com/2075-4418/13/11/1915

  Surgical resection comprises an important part of MB treatment plans, and the extent of resection poses a significant prognostic factor. […] The main goal of resection is the removal of the whole extent of the tumor, with gross total resection (GTR) demonstrating a favorable impact on both PFS and OS. […] There are four main histological subtypes of MBs: desmoplastic/nodular (DMN), classic (CMB), MBs with extensive nodularity (MBEN), and large cell/anaplastic (LCA). […] Each of them is characterized by different histological patterns and is associated with distinct molecular and genetic alterations, exhibiting diverse prognosis. […] The poor prognosis of that subtype could be attributed to the association of LCA with high-risk features, as it usually affects patients at a younger age, is diagnosed with metastasis at presentation, and is associated with specific molecular and genetic alternations such as LOH, isochromosome 17q, and MYC-family genes.

• #2 Risk factors and risk prediction model for recurrence in medulloblastoma – Ai – Translational Pediatrics

  https://tp.amegroups.org/article/view/133603/html

  In this study, we confirmed that the extent of disease dissemination, age at diagnosis, size of residual lesion after surgery, tumor histopathology, classification as G3, pre-treatment NLR are important prognostic factors for relapse after treatment of medulloblastoma. […] In summary, in the present study, we have developed and validated an nomogram for the prognosis of recurrent medulloblastoma by integrating independent prognostic indicators.

• #2 Prognostic classification of pediatric medulloblastoma based on chromosome 17p loss, expression of MYCC and MYCN, and Wnt pathway activation

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3266382/

  Diminished survival in age 3 years was more substantial in subgroups with high expression of MYCC, MYCN, or 17p loss but not in other subgroups, indicating that poor survival outcome might be synergistically affected by these 3 factors. […] Here we suggest a more tailored subgrouping system based on expression profiles of chromosome 17p, MYCC, and MYCN, which could provide the basis for a novel risk-stratification strategy in pediatric medulloblastoma. […] Based on the analysis of large combined data from several independent cohorts, we found that chromosome 17p loss and the expression levels of MYCC and MYCN are significant determinants for survival in medulloblastoma. […] Considering these 2 factors simultaneously, we could stratify patients into subgroups with distinct survival. […] The relationship between MYCC(N) and poor prognosis became more prominent after separation of the Wnt group from the medulloblastoma data set by reducing the confounding effect of the Wnt group because patients with high Wnt/-catenin signaling are often linked to good prognosis despite their elevated expression of MYCC and MYCN, which are known downstream targets of Wnt signaling. […] In conclusion, we suggest a more tailored subgrouping system based on expression profiles of chromosome 17p, MYCC, and MYCN, which could ultimately lead to the basis for a new risk-stratification strategy in medulloblastoma.

• #2 Deep learning models for predicting the survival of patients with medulloblastoma based on a surveillance, epidemiology, and end results analysis | Scientific Reports

  https://www.nature.com/articles/s41598-024-65367-9

  Medulloblastoma is a malignant neuroepithelial tumor of the central nervous system. Accurate prediction of prognosis is essential for therapeutic decisions in medulloblastoma patients. […] The DeepSurv model outperformed the RSF and classic CoxPH models with C-indexes of 0.751 and 0.763 for the training and test datasets. Additionally, the DeepSurv model showed better accuracy in predicting 1-, 3-, and 5-year survival rates (AUC: 0.7670.793). Therefore, our prediction model based on deep learning algorithms can more accurately predict the survival rate and survival period of medulloblastoma compared to other models. […] Certain prognostic features, such as age at diagnosis, extent of resection, histological subtype, and molecular subgroup classification, have been found to affect survival predictions in individual patients.

• #2 An online calculator using machine learning for predicting survival in pediatric patients with medulloblastoma in: Journal of Neurosurgery: Pediatrics Volume 33 Issue 1 (2023) Journals

  https://thejns.org/pediatrics/view/journals/j-neurosurg-pediatr/33/1/article-p85.xml

  Higher median household income and urban counties were associated with longer survival time in comparison with lower household income and rural attributes. […] Our model may be a useful adjunct to the current approach, providing a framework for clinicians and patients alike to consider prognosis during treatment planning. […] This study is the first to develop and validate a clinical prognostic calculator for pediatric medulloblastoma, providing an interactive, web-based platform for individualized expected survival. […] In this study, we developed a prognostic tool for predicting survival in pediatric patients with medulloblastoma. Despite having sufficient predictive power and good clinical application value, this model requires further addition of granular data and external validation with a more heterogeneous cohort to become clinically meaningful and useful.

• #2 Deep learning models for predicting the survival of patients with medulloblastoma based on a surveillance, epidemiology, and end results analysis | Scientific Reports

  https://www.nature.com/articles/s41598-024-65367-9

  The survival of medulloblastoma patients was significantly affected by non-surgical treatment, LC, white race, tumor size3.4 cm, total resection, age3 years, chemotherapy, and radiotherapy. […] The predictive performance of the three models is shown in Table 2. In the test dataset, the DeepSurv and RSF model exhibited better discrimination abilities (the DeepSurv C-index: 0.763, RSF: 0.759) compared with the CoxPH model (the C-index: 0.757). […] The study results demonstrated that the DeepSurv model outperformed both the CoxPH and RSF models, as indicated by its higher C-index in both the training and testing sets. Moreover, the DeepSurv model exhibited the lowest IBS and the largest AUC values when predicting 1-, 3-, and 5-year survival. These findings collectively suggest that the DeepSurv model is more accurate in predicting the survival of patients with medulloblastoma.

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