Retrospective Study on Surgical Outcome of Medulloblastoma among Operated Patients.
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Date
2025
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Addis Ababa Uinverstiy
Abstract
Medulloblastoma is a highly malignant primary central nervous system tumor
and the most common solid brain tumor in children, contributing substantially to childhood
cancer mortality. Pediatric cases often show more aggressive features, while adult tumors
tend to have better outcomes. Given these differences and the lack of adequate local
evidence, assessing surgical outcomes at Tikur Anbessa Specialized Hospital and MCM
hospital is important to guide clinical practice in Ethiopia.
Objective: To evaluate the surgical outcomes of patients with medulloblastoma who underwent
operative management at TASH, and MCM hospital Addis Ababa, Ethiopia, between May 1,
2018 - September 30, 2025.
Methodology: A two-hospital based retrospective cohort study was conducted on 47 patients
with medulloblastoma who underwent operative management from May 1, 2018 to September
30, 2025. Data were obtained from medical records, operative notes, pathology reports, and
pre- and postoperative imaging using a structured data extraction checklist. Descriptive
statistics were used to summarize patient characteristics, while Kaplan–Meier survival
analysis and Cox proportional hazards models were applied to assess progression-free and
overall survival and to identify factors associated with poor surgical and functional outcomes.
Statistical significance was set at a p-value < 0.05.
Result: The survival declined markedly, being alive, 37 (78.7%), 95% CI (65.5–88.5) at 1
month, decreasing to 36 (76.6%), 95% CI (63.2–86.9) at 6 months, then 22 (46.8%), 95% CI
(33.1–60.9) at 1 year, further to 11 (23.4%), 95% CI (13.1–36.8) at 2 years, and only 2 (4.3%),
95% CI (0.9–13.0) remaining alive at 3 years following surgery. No patient survived at 4 years
follow up. The analysis indicates that more complete intraoperative resection is associated
with better overall survival and longer progression-free survival. The patients with brainstem
compression (AOR = 52.544; 95% CI: 1.754–1574.066) and immediate postoperative
complications (AOR = 93.887; 95% CI: 1.985–4440.072), delayed initiation of radiotherapy
and younger age were significantly associated with poor functional outcomes in
medulloblastoma patients.
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Conclusion: In conclusion, survival among medulloblastoma patients declined progressively
after surgery, with better outcomes linked to complete tumor resection and older age groups.
Brainstem compression and immediate postoperative complications and luck of timely initiation
of oncologic intervention were associated with poor functional and survival outcomes,
underscoring the need for careful surgical management and postoperative care to improve
survival and recovery.
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Keywords
Medulloblastoma, Functional outcomes, Factors