Predictors of Outcome in Pediatric Medulloblastoma

Background: Medulloblastoma is the most common malignant brain tumor in children, arising in the cerebellum and representing a significant cause of morbidity and mortality in pediatric neuro-oncology. This study was don to evaluate clinical, radiological, and surgical predictors of short-term outcomes in pediatric patients diagnosed with medulloblastoma. Methods: This retrospective, analytical, observational cohort study was conducted at the Pediatric Neurosurgery Department of the Children's Hospital and the Institute of Child Health, Multan, Pakistan, from January 2022 to March 2025. Data of children aged 1 to 12 years, histologically confirmed medulloblastoma, and underwent surgical intervention, were analyzed. Non-probability consecutive sampling technique was adopted. Short-term outcomes were documented in terms of mortality, and postoperative complications at 12-months. Data were analyzed using IBM SPSS Statistics version 26.0. Associations with 12-month mortality were assessed using chi-square or Fisher’s exact test. Results: Among 60 children with medulloblastoma, 39 (65.0%) were male, and the mean age was 6.80±2.60 years. Gross-total resection was achieved in 32 (53.3%) cases. Postoperative complications included CSF leak and meningitis in 11 (18.3%) each. Classic histology was most common (63.3%). Radiotherapy and chemotherapy were administered in 88.3% and 85.0% of cases, respectively. Survival analysis estimated a 12-month overall survival of 90.0%. Mortality was significantly associated with younger age (p=0.008), short symptom duration (p=0.039), altered consciousness (p=0.005), metastasis (p=0.004), subtotal resection (p<0.001), meningitis (p=0.005), and anaplastic histology (p=0.008). Conclusion: Relatively younger age, short symptom duration, altered consciousness at presentation, metastatic disease, subtotal resection, postoperative meningitis, and large cell/anaplastic histology were significantly contributors to 12-month mortality.