Population-based Study of Medulloblastoma: Outcomes in Alberta from 1975 to 1996

Background:The purpose of this study was to determine incidence, survival rate, and prognostic factors as well as the frequency of Collins’ Law Violators (CLVs) in an unselected population of medulloblastoma patients. Collins’ Law dictates that ’cure’ of a child with a tumor occurs after a period that includes the child’s age at diagnosis plus 9 months.Methods:Using the Alberta Cancer Registry a population-based review identified 49 patients with medulloblastoma (19 adults, 30 children) diagnosed from 1975-96. Pathology was reviewed in all cases. All patients had surgical resection, followed by radiotherapy in 47 patients and chemotherapy in 17.Results:The overall 5-year survival was 50%. There was a trend for the extent of resection to be associated with a longer survival (Long rank test, p< 0.06) but this was not significant. Tumor recurrence occurred a median of 22.4 months (range, 6.4-192.3) after diagnosis and median survival after recurrence was 9.3 months (range, 0.4-64.9). The survival curve did not appear to plateau but was affected by tumor-related deaths in 3 (21.4%) of the 21 long-term survivors diagnosed in childhood. These three patients had recurrences a mean of 11.7 years after diagnosis and are designated as CLVs.Conclusions:The survival rate in an unselected population of patients with medulloblastoma is poor. Aggressive resection of the tumors prolongs survival. The Collins’ Law Violators were relatively common and we suggest this concept be abandoned in medulloblastoma.

Download Full-text

Life after childhood cancer: marriage and offspring in adult long-term survivors – a population-based study in the Piedmont region, Italy

European Journal of Cancer Prevention ◽

10.1097/cej.0b013e3283307770 ◽

2009 ◽

Vol 18 (6) ◽

pp. 425-430 ◽

Cited By ~ 14

Author(s):

Elisa Dama ◽

Milena M. Maule ◽

Maria L. Mosso ◽

Daniela Alessi ◽

Micaela Ghisleni ◽

...

Keyword(s):

Childhood Cancer ◽

Population Based ◽

Population Based Study ◽

Long Term Survivors ◽

Piedmont Region

Download Full-text

Health‐Related Quality of Life Among Long‐Term Survivors of Colorectal Cancer: A Population‐Based Study

The Oncologist ◽

10.1634/theoncologist.2011-0036 ◽

2011 ◽

Vol 16 (11) ◽

pp. 1626-1636 ◽

Cited By ~ 56

Author(s):

Agnès Caravati‐Jouvenceaux ◽

Guy Launoy ◽

Delphine Klein ◽

Michel Henry‐Amar ◽

Edwige Abeilard ◽

...

Keyword(s):

Quality Of Life ◽

Colorectal Cancer ◽

Population Based ◽

Health Related Quality ◽

Population Based Study ◽

Related Quality ◽

Health Related ◽

Long Term Survivors

Download Full-text

Maternal Hypothyroidism during Pregnancy and the Risk of Pediatric Endocrine Morbidity in the Offspring

American Journal of Perinatology ◽

10.1055/s-0038-1675834 ◽

2018 ◽

Vol 36 (09) ◽

pp. 975-980 ◽

Cited By ~ 2

Author(s):

Tamar Eshkoli ◽

Tamar Wainstock ◽

Eyal Sheiner ◽

Ofer Beharier ◽

Merav Fraenkel ◽

...

Keyword(s):

Cox Regression ◽

Survival Curve ◽

Mode Of Delivery ◽

Cumulative Risk ◽

Maternal Diabetes ◽

Population Based ◽

Rank Test ◽

Increased Risk

Objective Previous studies suggested maternal hypothyroidism during pregnancy to be associated with cognitive impairment of the offspring. Scarce data exist regarding long-term endocrine health of the offspring. This study was aimed to assess whether children born to mothers with hypothyroidism during pregnancy are at an increased risk for long-term endocrine morbidity. Study Design A retrospective population-based cohort study compared long-term endocrine morbidity of children born between the years 1991 and 2014 to mothers with and without hypothyroidism. Multiple gestations, fetuses with congenital malformations, and women lacking prenatal care were excluded. Hospitalizations of the offspring up to the age of 18 years involving endocrine morbidity were evaluated according to a predefined set of ICD-9 codes. Kaplan–Meier's survival curves were used to compare the cumulative risk and a Cox multivariable model was used to adjust for confounders. Results During the study period, 217,910 deliveries met the inclusion criteria; 1.1% of which were with maternal hypothyroidism (n = 2,403). During the follow-up period, the cumulative incidence of endocrine morbidity among children born to mothers with hypothyroidism was 27 per 1,000 person-years and 0.47 per 1,000 person-years in the comparison group (relative risk: 2.14; 95% confidence interval [CI]: 1.21–3.79). The Kaplan–Meier's survival curve demonstrated a significantly higher cumulative endocrine morbidity in children born to mothers with hypothyroidism (log-rank test, p = 0.007). In the Cox regression model controlled for maternal age, birth weight, preterm birth, maternal diabetes, hypertensive disorders of pregnancy, induction of labor, and mode of delivery, maternal hypothyroidism was found to be independently associated with pediatric endocrine morbidity in the offspring (adjusted hazard ratio = 1.92, 95% CI: 1.08–3.4, p = 0.025). Conclusion Maternal hypothyroidism appears to be independently associated with long-term pediatric endocrine morbidity of the offspring.

Download Full-text