Medulloblastoma staging

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Syed Musadiq Ali M.B.B.S.[2]Haytham Allaham, M.D. [3]

Overview

The staging of medulloblastoma is based on the modified Chang’s staging system. Medulloblastoma patients are risk stratified into either a standard risk group or a high risk group based on the tumor stage, the patient’s age, and the extent of any previous surgical resection.^[1]^[2]

Modified Chang’s Staging of Medulloblastoma

The staging of medulloblastoma is based on the modified Chang staging system.^[1]

T: Primary Tumor

T	Description
TX	Primary tumor cannot be assessed
T0	There is no evidence of primary tumor
T1	Tumor size <3 cm in diameter
T2	Tumor size ≥3 cm in diameter with no evidence of extension
T3a	Tumor size >3 cm in diameter with extension into aqueduct of Sylvius or foramen of Luschka
T3b	Tumor size >3 cm in diameter with definite spread into the brain stem
T4	Tumor size >3 cm in diameter with extension past aqueduct of Sylvius or down past foramen magnum

M: Distant Metastasis

M	Description
M0	No evidence of metastasis
M1	Microscopic tumor cells present in the cerebrospinal fluid
M2	Gross nodular seeding present intracranially beyond the primary tumor site
M3	Gross nodular seeding present in the spinal subarachnoid space
M4	Metastasis present outside the cerebrospinal axis

Risk Stratification

Medulloblastoma patients are risk stratified into either a standard risk group or a high risk group based on the tumor stage, the patient’s age, and the extent of any previous surgical resection.^[3]
Risk stratification determines the protocol of management used for medulloblastoma patients.
The table below demonstrates the risk stratification for medulloblastoma patients:^[3]^[2]


Parameters	Standard Risk Group	High Risk Group

Age	Patients older than 3 years of age	Patients younger than 3 years of age
Extent of previous surgical resection	<1.5 cm² residual tumor after resection	Subtotal resection or >1.5 cm² residual tumor after resection
Tumor stage	M0 stage confirmed by MRI and CSF sampling	M1-M3 stage or presence of leptomeningeal seeding

References

↑ ^1.0 ^1.1 Harisiadis L, Chang CH (1977). “Medulloblastoma in children: a correlation between staging and results of treatment”. Int J Radiat Oncol Biol Phys. 2 (9–10): 833–41. PMID 597384.
↑ ^2.0 ^2.1 Medulloblastoma staging. Wikibooks(2015) https://en.wikibooks.org/wiki/Radiation_Oncology/Medulloblastoma/Staging Accessed on September, 282015)
↑ ^3.0 ^3.1 Bartlett F, Kortmann R, Saran F (2013). “Medulloblastoma”. Clin Oncol (R Coll Radiol). 25 (1): 36–45. doi:10.1016/j.clon.2012.09.008. PMID 23245832.

[pmid597384-1] 1.0 ^1.1 Harisiadis L, Chang CH (1977). “Medulloblastoma in children: a correlation between staging and results of treatment”. Int J Radiat Oncol Biol Phys. 2 (9–10): 833–41. PMID 597384.

[b-2] 2.0 ^2.1 Medulloblastoma staging. Wikibooks(2015) https://en.wikibooks.org/wiki/Radiation_Oncology/Medulloblastoma/Staging Accessed on September, 282015)

[pmid23245832-3] 3.0 ^3.1 Bartlett F, Kortmann R, Saran F (2013). “Medulloblastoma”. Clin Oncol (R Coll Radiol). 25 (1): 36–45. doi:10.1016/j.clon.2012.09.008. PMID 23245832.

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