Survival rate describes the percentage of people who are alive a certain number of years after diagnosis. Survival depends on age, whether the tumor has spread and the tumor's molecular type.
Survival in children
Factors such as age, tumor type, and whether or not the tumor has metastasized can affect survival rates.
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Five-year survival. About 70% to 85% of children with average-risk medulloblastoma are alive five years after diagnosis. Average risk means the tumor has not spread and most of it was removed during surgery.
Many children with average-risk medulloblastoma can be cured with treatment.
Survival is lower when the tumor has spread to the brain or spinal cord at diagnosis or when a large amount of tumor remains after surgery. In these higher risk cases, five-year survival may be closer to 60%.
- 10-year survival. Long-term survival beyond five years is common, especially when the tumor has not spread and responds well to treatment.
Survival in children with medulloblastoma depends mainly on the type of tumor and whether it has metastasized.
- WNT-activated. Children with WNT-activated medulloblastoma often have the highest survival rates. With treatment, the five-year survival rate can be higher than 90%.
- SHH-activated. Survival varies in SHH-type tumors. Some respond well to treatment, especially when certain high-risk gene changes are not present, such as with SHH-activated TP53-wildtype. Other SHH tumors, such as SHH-activated TP53-mutant, may grow faster, metastasize more easily or be harder to treat.
- Group 3. Group 3 tumors tend to be more aggressive, especially when the tumor has metastasized. Survival rates are generally lower than in WNT-activated tumors.
- Group 4. This type is the most common type of medulloblastoma. Survival is usually between that of WNT-activated and group 3 tumors and depends on whether the tumor has metastasized and other features.
Infants and very young children may have lower survival rates because radiation treatment is limited to protect brain development.
Survival in adults
Survival rates in adults depend on the tumor type and whether the cancer has metastasized. Outcomes also are affected by how much tumor remains after surgery and by tumor features linked to faster growth. Survival may be lower in adults whose tumors have spread or have large cell features.
- Five-year survival rate. In a modern single-center study of adults treated with surgery, radiation therapy and chemotherapy, about 86% were alive five years after diagnosis.
- 10-year survival rate. Research shows that about 64% of adults were alive 10 years after diagnosis.
Recurrence rates
The cancer grows back, also called recurs, after treatment in about 20% to 30% of children with medulloblastoma. The risk of recurrence is higher when the tumor has metastasized by the time of diagnosis or in certain tumor types, such as some group 3 tumors.
Most recurrences in children happen within the first three years after diagnosis, often within the first year in those at higher risk. In adults, recurrence may occur later.
Recurrence can happen in the original tumor area, elsewhere in the brain or in the spinal cord. When medulloblastoma comes back, it is usually harder to treat and survival rates are lower.
Prognosis
Prognosis refers to the likely outcome of a disease. With treatment options available today, many children with medulloblastoma survive for many years after diagnosis. Outcomes vary based on several factors.
Adults and children may experience the disease differently. Children are more likely to have long-term side effects from treatment that affect growth, learning and hormone function. These effects can include slower physical development, difficulty with memory or attention, and changes in puberty or fertility. Adults may experience later recurrences and treatment-related side effects that affect work and daily activities.
What affects prognosis?
The outlook for medulloblastoma depends on:
- The person's age.
- Whether the tumor has metastasized to the brain or spinal cord.
- How much of the tumor was safely removed during surgery.
- The tumor's molecular type, such as WNT-activated, SHH-activated (TP53-wildtype or TP53-mutant), group 3 or group 4.
- Results of lab testing of the tumor cells.
Tumors that have not spread and can be mostly removed often have better outcomes. Some molecular types, such as WNT-activated tumors, are linked to higher survival rates. Others, such as certain group 3 tumors, may be more aggressive and have a poorer prognosis.
Is medulloblastoma curable?
Many children with medulloblastoma can be cured, especially when the tumor is found early and has not spread. Adults also can be successfully treated, but outcomes may vary more widely.