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Refining M1 stage in medulloblastoma: criteria for cerebrospinal fluid cytology and implications for improved risk stratification from the HIT-2000 trial

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Refining M1 stage in medulloblastoma: criteria for cerebrospinal fluid cytology and implications for improved risk stratification from the HIT-2000 trial. / Hagel, Christian; Sloman, Veronika; Mynarek, Martin; Petrasch, Katharina; Obrecht, Denise; Kühl, Joachim; Deinlein, Frank; Schmid, Renate; von Bueren, André O; Friedrich, Carsten; Juhnke, B Ole; Gerber, Nicolas U; Kwiecien, Robert; Girschick, Hermann; Höller, Alexandra; Zapf, Antonia; von Hoff, Katja; Rutkowski, Stefan.

In: EUR J CANCER, Vol. 164, 03.2022, p. 30-38.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Hagel, C, Sloman, V, Mynarek, M, Petrasch, K, Obrecht, D, Kühl, J, Deinlein, F, Schmid, R, von Bueren, AO, Friedrich, C, Juhnke, BO, Gerber, NU, Kwiecien, R, Girschick, H, Höller, A, Zapf, A, von Hoff, K & Rutkowski, S 2022, 'Refining M1 stage in medulloblastoma: criteria for cerebrospinal fluid cytology and implications for improved risk stratification from the HIT-2000 trial', EUR J CANCER, vol. 164, pp. 30-38. https://doi.org/10.1016/j.ejca.2021.12.032

APA

Hagel, C., Sloman, V., Mynarek, M., Petrasch, K., Obrecht, D., Kühl, J., Deinlein, F., Schmid, R., von Bueren, A. O., Friedrich, C., Juhnke, B. O., Gerber, N. U., Kwiecien, R., Girschick, H., Höller, A., Zapf, A., von Hoff, K., & Rutkowski, S. (2022). Refining M1 stage in medulloblastoma: criteria for cerebrospinal fluid cytology and implications for improved risk stratification from the HIT-2000 trial. EUR J CANCER, 164, 30-38. https://doi.org/10.1016/j.ejca.2021.12.032

Vancouver

Hagel C, Sloman V, Mynarek M, Petrasch K, Obrecht D, Kühl J et al. Refining M1 stage in medulloblastoma: criteria for cerebrospinal fluid cytology and implications for improved risk stratification from the HIT-2000 trial. EUR J CANCER. 2022 Mar;164:30-38. https://doi.org/10.1016/j.ejca.2021.12.032

Bibtex

@article{f31f828bd0aa49e796f2320291f12423,
title = "Refining M1 stage in medulloblastoma: criteria for cerebrospinal fluid cytology and implications for improved risk stratification from the HIT-2000 trial",
abstract = "BACKGROUND: Medulloblastoma is the most common malignant paediatric brain tumour, and cerebrospinal fluid (CSF) dissemination (M1 stage) is a high-risk prognostic factor. Criteria for CSF evaluation and for differentiating M0 from M1 stage are not clearly defined, and the prognostic significance of M1 stage in this context is unknown.PATIENTS AND METHODS: CSF investigations from 405 patients with medulloblastoma of the prospective multicenter trial HIT-2000 (HIirnTumor-2000) were reviewed. Data from 213 patients aged ≥4 years were related to 5-year progression-free (5y-PFS) and overall survival.RESULTS: Patients with cytological tumour dissemination only (M1 stage only) aged ≥4 years (n = 18) and patients with radiologically detected metastases (M2/3, n = 85) showed a worse 5y-PFS than M0 patients (n = 110) without signs of metastatic disease (5y-PFS 61.1% and 59.6% vs 80.7%; p < 0.02 and p < 0.01, log rank). Patients with positive samples drawn early after surgery who turned negative within 14 days postoperatively (n = 9) and patients with atypical cells (n = 6) showed a 5y-PFS similar to M0 patients. No tumour cells were detected in samples containing <10 nucleated cells. Analysis of cytological criteria showed a better predictive value for tumour cell clusters than ≥2 individual tumour cells.CONCLUSION: Based on our results, we suggest that CSF medulloblastoma staging should be performed 14 days postoperatively by lumbar puncture, and specimens should contain at least 10 nucleated cells. Cytological tumour dissemination alone (M1 stage only) appears a high-risk prognostic factor associated with an outcome comparable to M2/M3 stage. Tumour cell clusters seem to have a greater impact on prognosis than single tumour cells. This should be validated further.",
author = "Christian Hagel and Veronika Sloman and Martin Mynarek and Katharina Petrasch and Denise Obrecht and Joachim K{\"u}hl and Frank Deinlein and Renate Schmid and {von Bueren}, {Andr{\'e} O} and Carsten Friedrich and Juhnke, {B Ole} and Gerber, {Nicolas U} and Robert Kwiecien and Hermann Girschick and Alexandra H{\"o}ller and Antonia Zapf and {von Hoff}, Katja and Stefan Rutkowski",
note = "Copyright {\textcopyright} 2022 Elsevier Ltd. All rights reserved.",
year = "2022",
month = mar,
doi = "10.1016/j.ejca.2021.12.032",
language = "English",
volume = "164",
pages = "30--38",
journal = "EUR J CANCER",
issn = "0959-8049",
publisher = "Elsevier Limited",

}

RIS

TY - JOUR

T1 - Refining M1 stage in medulloblastoma: criteria for cerebrospinal fluid cytology and implications for improved risk stratification from the HIT-2000 trial

AU - Hagel, Christian

AU - Sloman, Veronika

AU - Mynarek, Martin

AU - Petrasch, Katharina

AU - Obrecht, Denise

AU - Kühl, Joachim

AU - Deinlein, Frank

AU - Schmid, Renate

AU - von Bueren, André O

AU - Friedrich, Carsten

AU - Juhnke, B Ole

AU - Gerber, Nicolas U

AU - Kwiecien, Robert

AU - Girschick, Hermann

AU - Höller, Alexandra

AU - Zapf, Antonia

AU - von Hoff, Katja

AU - Rutkowski, Stefan

N1 - Copyright © 2022 Elsevier Ltd. All rights reserved.

PY - 2022/3

Y1 - 2022/3

N2 - BACKGROUND: Medulloblastoma is the most common malignant paediatric brain tumour, and cerebrospinal fluid (CSF) dissemination (M1 stage) is a high-risk prognostic factor. Criteria for CSF evaluation and for differentiating M0 from M1 stage are not clearly defined, and the prognostic significance of M1 stage in this context is unknown.PATIENTS AND METHODS: CSF investigations from 405 patients with medulloblastoma of the prospective multicenter trial HIT-2000 (HIirnTumor-2000) were reviewed. Data from 213 patients aged ≥4 years were related to 5-year progression-free (5y-PFS) and overall survival.RESULTS: Patients with cytological tumour dissemination only (M1 stage only) aged ≥4 years (n = 18) and patients with radiologically detected metastases (M2/3, n = 85) showed a worse 5y-PFS than M0 patients (n = 110) without signs of metastatic disease (5y-PFS 61.1% and 59.6% vs 80.7%; p < 0.02 and p < 0.01, log rank). Patients with positive samples drawn early after surgery who turned negative within 14 days postoperatively (n = 9) and patients with atypical cells (n = 6) showed a 5y-PFS similar to M0 patients. No tumour cells were detected in samples containing <10 nucleated cells. Analysis of cytological criteria showed a better predictive value for tumour cell clusters than ≥2 individual tumour cells.CONCLUSION: Based on our results, we suggest that CSF medulloblastoma staging should be performed 14 days postoperatively by lumbar puncture, and specimens should contain at least 10 nucleated cells. Cytological tumour dissemination alone (M1 stage only) appears a high-risk prognostic factor associated with an outcome comparable to M2/M3 stage. Tumour cell clusters seem to have a greater impact on prognosis than single tumour cells. This should be validated further.

AB - BACKGROUND: Medulloblastoma is the most common malignant paediatric brain tumour, and cerebrospinal fluid (CSF) dissemination (M1 stage) is a high-risk prognostic factor. Criteria for CSF evaluation and for differentiating M0 from M1 stage are not clearly defined, and the prognostic significance of M1 stage in this context is unknown.PATIENTS AND METHODS: CSF investigations from 405 patients with medulloblastoma of the prospective multicenter trial HIT-2000 (HIirnTumor-2000) were reviewed. Data from 213 patients aged ≥4 years were related to 5-year progression-free (5y-PFS) and overall survival.RESULTS: Patients with cytological tumour dissemination only (M1 stage only) aged ≥4 years (n = 18) and patients with radiologically detected metastases (M2/3, n = 85) showed a worse 5y-PFS than M0 patients (n = 110) without signs of metastatic disease (5y-PFS 61.1% and 59.6% vs 80.7%; p < 0.02 and p < 0.01, log rank). Patients with positive samples drawn early after surgery who turned negative within 14 days postoperatively (n = 9) and patients with atypical cells (n = 6) showed a 5y-PFS similar to M0 patients. No tumour cells were detected in samples containing <10 nucleated cells. Analysis of cytological criteria showed a better predictive value for tumour cell clusters than ≥2 individual tumour cells.CONCLUSION: Based on our results, we suggest that CSF medulloblastoma staging should be performed 14 days postoperatively by lumbar puncture, and specimens should contain at least 10 nucleated cells. Cytological tumour dissemination alone (M1 stage only) appears a high-risk prognostic factor associated with an outcome comparable to M2/M3 stage. Tumour cell clusters seem to have a greater impact on prognosis than single tumour cells. This should be validated further.

U2 - 10.1016/j.ejca.2021.12.032

DO - 10.1016/j.ejca.2021.12.032

M3 - SCORING: Journal article

C2 - 35151105

VL - 164

SP - 30

EP - 38

JO - EUR J CANCER

JF - EUR J CANCER

SN - 0959-8049

ER -