Evidence map›Paper›PMID 31686139›Full record

ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2019

Childhood medulloblastoma-a single institution's historical perspective on survival and functional morbidity.

Kim Phipps, Matthew A Kirkman, Kristian Aquilina, Mark Gaze, Antony Michalski, Angie Wade, Richard Hayward

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Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Kim PhippsDepartment of Neurosurgery, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC2N 3JH, UK.
Matthew A KirkmanDepartment of Neurosurgery, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC2N 3JH, UK.
Kristian AquilinaDepartment of Neurosurgery, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC2N 3JH, UK.
Mark GazeDepartment of Haematology and Oncology, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC2N 3JH, UK.
Antony MichalskiDepartment of Haematology and Oncology, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC2N 3JH, UK.
Angie WadePopulation, Policy and Practice Programme, Great Ormond Street Institute of Child Health, UCL, 30 Guilford Street, London, WC1N 1EH, UK.
Richard HaywardDepartment of Neurosurgery, Great Ormond Street Hospital for Children NHS Foundation Trust, Great Ormond Street, London, WC2N 3JH, UK. Richard.hayward@gosh.nhs.uk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo compare results from a third (1995-2010) cohort of children with medulloblastoma with two previous series (J Neurosurg 86:13-21, 1997; Arch Dis Child 54:200-203, 1979) to analyse the effects of management changes aimed at improving both overall and event-free survivals (OS and EFS) and functional outcomes.

methodsReview of neuro-oncology and imaging databases and previously published results.

resultsThere was no statistically significant improvement in the 5-year OS for 104 children diagnosed 1995-2010, 61.5% (95% CI, 52.9, 71.6), compared with 50% of the 80 children presenting 1980-1990 (J Neurosurg 86:13-21, 1997) (difference 11.5%; 95% CI, 2.8, 25.4). Five-year OS for 96 children suitable for risk-stratification was overall 66% (95% CI, 57.9, 75.8); standard risk 77.8% (95% CI, 67.4, 89.7); high risk < 3 years 50.0% (95% CI, 32.3, 77.5); high risk ≥ 3 years 54.5% (95% CI, 37.2, 79.9); 5-year EFS were standard risk 68.5% (95% CI, 57.2, 82.1); high risk < 3 years 40.0% (95% CI, 23.4, 68.4); and high risk ≥ 3 years 36.4% (95% CI, 20.9, 63.2); overall 55.2% (95% CI, 46.1, 66.1). Of 62/63 ≥ 5-year survivor, 9 died later from tumour relapse and 4 from second malignancy. Functional outcomes of 62 of the 63 ≥ 5-year survivors: 67.7% had educational issues requiring remedial input; 18% restricted mobility indoors and outdoors; 59.7% hearing impairment (42% prescribed aids).

conclusions1. Comparison of this single-institution series with its predecessor found that revised chemotherapy and RT protocols and greater accuracy of risk stratification did not result in statistically significant improvements in either survival or treatment-related functional disability. 2. Extended (> 5-year) follow-up is essential if 20% of late deaths from relapse and second malignancies are not to be overlooked.

Indexed as

Recovery of FunctionAdolescentAntineoplastic Combined Chemotherapy ProtocolsCerebellar NeoplasmsChemotherapy, AdjuvantChildChild, PreschoolDisease-Free SurvivalFemaleHumansInfantInfant, NewbornMaleMedulloblastomaNeurosurgical ProceduresRadiotherapy, AdjuvantChemotherapy,Functional outcomeMedulloblastomaNeurosurgery,Radiotherapy

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.