INFLUENCE OF A CHILDS SEX ON MEDULLOBLASTOMA OUTCOME

Context.-Aggressive treatment of medulloblastoma, the most common pedi atric brain tumor, has not improved survival. Identifying better progn ostic indicators may warrant less morbid therapy. Objective.-To invest igate the role of sex on outcome of medulloblastoma. Design.-Retrospec tive study of significant factors for survival with a median follow-up of 82 months. Setting.-University medical center. Patients.-A total o f 109 consecutive, pediatric patients treated for primary medulloblast oma from 1970 to 1995 with surgery and postoperative radiotherapy and, after 1979, chemotherapy. Main Outcome Measures.-Factors independentl y associated with survival. Results.-The final multivariate model pred icting improved survival included sex (hazard ratio, 0.52; 95% confide nce interval [CI], 0.29-0.92; P=.03; favoring female), metastases at p resentation (hazard ratio, 2.01,95% CI, 1.14-3.52; P=.02), and extent of surgical resection (hazard ratio, 0.60; 95% CI, 0.34-1.04; P=.07; f avoring greater resection). The overall, 5-year freedom from progressi on was 40% and survival was 49%. Radiotherapy dose (P=.72), and chemot herapy (P=.90) did not significantly affect a disease outcome. Conclus ions.-The sex of the child was an important predictor for survival of medulloblastoma; girls had a much better outcome. The difference in su rvival between sexes should be evaluated in prospective, clinical tria ls.