Article
Why do long-term survivors of childhood medulloblastoma die? A meta-analysis on cause-specific late mortality
Was sind die Todesursachen von Langzeitüberlebenden nach kindlichem Medulloblastom? Eine Meta-Analyse der ursachenspezifischen Mortalität
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Authors
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Hendrik-Jan Mijderwijk
- Universitätsklinikum Düsseldorf, Klinik für Neurochirurgie, Düsseldorf, Deutschland
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Daniel Hänggi
- Universitätsklinikum Düsseldorf, Klinik für Neurochirurgie, Düsseldorf, Deutschland
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Christopher Munoz-Bendix
- Universitätsklinikum Düsseldorf, Klinik für Neurochirurgie, Düsseldorf, Deutschland
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Thomas Beez
- Universitätsklinikum Düsseldorf, Klinik für Neurochirurgie, Düsseldorf, Deutschland
| Published: | May 25, 2022 |
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Outline
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Objective: Long-term survival in children suffering from medulloblastoma is commonly evaluated with analysis reporting on all-cause mortality. There is a paucity on analyses that report on cause-specific mortality in these patients. Yet, this is highly relevant regarding duration of follow-up and imaging surveillance. We performed a proportional meta-analysis on cause-specific mortality in long-term childhood medulloblastoma survivors.
Methods: A comprehensive systematic literature search was performed on Medline, Embase, Web of Science, Cochrane and Google Scholar. Children suffering from medulloblastoma surviving at least 5 years after diagnosis were labelled as long-term survivors and eligible for inclusion in the analysis accordingly. Cause-specific mortality was divided into 1) recurrence or progression of medulloblastoma; 2) subsequent neoplasms; 3) other health-related causes not a result of medulloblastoma; 4) and miscellaneous causes (accidents, suicide, unknown causes). Analysis on the pooled data were performed using JBI SUMARI.
Results: Of the 344 identified studies, 4 studies reported on cause-specific mortality in long-term childhood medulloblastoma survivors. Cause-specific mortality data among 1917 patients was available. The pooled proportion of the random effects models equaled 0.121 (95% CI 0.103 – 0.141) for death related to recurrence or progression of medulloblastoma, 0.033 (95% CI 0.020 – 0.047) for death related to subsequent neoplasms, 0.034 (95% CI 0.002 – 0.097) for other health-related causes of death, and 0.018 (95% CI 0.000 – 0.065) for miscellaneous causes of death (Forrest plots, Figure 1 [Fig. 1] and Figure 2 [Fig. 2]).
Conclusion: This meta-analysis shows that circa 12% of long-term medulloblastoma survivors may die from tumor recurrence or progression. Death resulting from subsequent neoplasms or other (health-related) causes of death was less common, each <5%. To reduce late mortality, life-long guidance and personalized follow-up including imaging surveillance by health care professionals seems indicated.
