Relative survival of childhood and adult medulloblastomas and primitive neuroectodermal tumors (PNETs)†
Version of Record online: 11 AUG 2011
Copyright © 2011 American Cancer Society
Volume 118, Issue 5, pages 1313–1322, 1 March 2012
How to Cite
Smoll, N. R. (2012), Relative survival of childhood and adult medulloblastomas and primitive neuroectodermal tumors (PNETs). Cancer, 118: 1313–1322. doi: 10.1002/cncr.26387
I thank Associate Professor Elmer Villanueva for his continued support and mentorship. I thank Gregory Riggins, Gary Gallia, and their laboratory fellows at Johns Hopkins University; Professor Rosenfeld at the Alfred; and Dr. Drummond and Professor Rosenthal at Royal Melbourne Hospital for their comments on this work. I also thank Ms. Laetitia Smoll for her review of this article.
- Issue online: 17 FEB 2012
- Version of Record online: 11 AUG 2011
- Manuscript Accepted: 8 JUN 2011
- Manuscript Revised: 29 MAY 2011
- Manuscript Received: 27 APR 2011
- primitive neuroectodermal tumor;
- relative survival;
- covariate-by-follow-up interaction;
- survival modeling
Medulloblastomas are 1 of the most common brain tumors in children but can affect individuals of all ages. For this report, the author investigated the impact of medulloblastomas/primitive neuroectodermal tumors (PNETs) on the US population with a focus on age differences.
Data from the Surveillance, Epidemiology, and End Results (SEER) database were used to describe cumulative relative survival (CRS) using crude, period, and longitudinal period approaches for patients diagnosed with all medulloblastoma subtypes and PNETs. CRS estimates were obtained using SEER expected mortality data and the Ederer II method for expected survival estimation. These data were applied to the construction of rational follow-up scheduling protocols.
The 5-year period CRS for all patients who were followed between 2001 and 2006 was 69%. Adults had a worse overall prognosis, but this difference in excess hazard rates appeared only after 4 years of follow-up. Furthermore, the 5-year and 10-year CRS has improved a minimum of 11% in children, adolescents, and adults over the past 25 years.
The survival difference between children, adolescents, and adults with medulloblastomas and PNETs depended on the length of follow-up, which was described in this report as an age-by-follow-up interaction and observed as a “fork” on Kaplan-Meier curves. Differences in survival between children and adults emerged only 4 years after diagnosis, and adults fared worse. There has been significant improvement in survival from medulloblastomas/PNETs since the late 1970s and early 1980s. Cancer 2012;. © 2011 American Cancer Society.