COLLINS LAW - PREDICTION OF RECURRENCE OR CURE IN CHILDHOOD MEDULLOBLASTOMA

Collins' law, known as period of risk for recurrence (PRR), has been d iscussed as a reliable scheme for the prediction of recurrence or cure of embryonal tumours including medulloblastomas. The PRR is defined a s the age at diagnosis plus 9 months of gestation. According to Collin s' law, a patient who has no clinical evidence of recurrence within th is time period is considered cured. We have applied this system to 66 patients (age range from 0 to 47 years) who underwent surgery for medu lloblastoma at a single center between 1975 and 1990. Three patients i n whom a recurrence could not be verified died within 6 months. Eight patients (12.1%, age range from 1 to 14 years) survived the PRR withou t relapse and are free of risk for recurrence according to Collins' la w. Of the remaining 55 patients, 35 showed a relapse within the PRR wi th a mean latency of 18 months (0-78); Twenty patients are alive with no recurrence as yet, but are still within the PRR Three patients had non-recurrent benign brain tumours not connected to the initial tumour s with a mean latency of 10 (8-14) years after medulloblastoma surgery . Thus, all our patients fulfilled the criteria for Collins' law. In c onclusion, a patient's risk for medulloblastoma recurrence is signific antly higher before than after the completion of the PRR. Therefore, t he PRR is a helpful prognostic parameter that provides additional info rmation about the risk of medulloblastoma recurrence. A medulloblastom a cure cannot be presumed with certainty by Collins' law because relap ses after the PRR have been reported in other studies (1.4% of the cas es). Intracranial lesions detected after a long follow-up might be rad iotherapeutically induced second tumours. (C) 1997 Elsevier Science B. V.