THE APPLICABILITY OF COLLINS LAW TO CHILDHOOD BRAIN-TUMORS AND ITS USEFULNESS AS A PREDICTOR OF SURVIVAL

IN 1955, COLLINS made the observation that tumor recurrence in childre n with Wilms' tumor was correlated with the child's age plus 9 months. This concept of a period of risk for recurrence was later applied to a variety of tumors in children and became known as Collins' Law (CL). The law has been a successful predictor of survival for some children with neural tumors within the central nervous system and a poor predi ctor for others. We tested Collins' concept of a period of risk for re currence and extended it to survival for 14 childhood neural tumors de scribed in the Childhood Brain Tumor Consortium (CBTC) database. The C BTC data describe clinical, surgical, and histological details (over a 49-year period in 10 institutions) from 3921 patients under the age o f 21 years at the time of their first surgical procedure for a brain t umor. CL was considered to be a good predictor of survival if fewer th an 10% of patients who die survive beyond the expiration of the period of risk for that child. We found that CL applied to tumors such as an aplastic astrocytoma, glioblastoma, pineoblastoma, medulloblastoma or ''primitive neuroectodermal tumor,'' teratoma, and germinoma, as well as ependymoma, papilloma, and tumors that could not be classified; it had no predictive value in craniopharyngioma, oligodendroglioma, or pl ain, fibrillary, pilocytic, or protoplasmic astrocytoma. We had suffic ient follow-up data to determine adherence to CL when the child's age at diagnosis was less than 8 years; it is likely that CL applies to ol der children with these tumors, but we did not have the data to show t his unequivocally.