Clinico-Radiological Profile, Management Strategies, and Survival Outcomes in Medulloblastoma: A Retrospective Study From a Tertiary Care Center.
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Background Medulloblastoma is the most common malignant pediatric brain tumor. While survival outcomes have improved in high-income countries, results in low- and middle-income countries (LMICs) remain limited by delayed presentation, socioeconomic constraints, and incomplete adjuvant therapy. Hence, this study aimed to evaluate the clinico-radiological profile, management strategies, and prognostic factors influencing survival in patients with medulloblastoma treated at a tertiary neurosurgical center. Methodology A total of 56 patients with histologically confirmed medulloblastoma operated on between January 2019 and March 2024 were retrospectively analyzed. Clinical, radiological, surgical, and treatment data were collected. Survival was estimated using Kaplan-Meier analysis and compared using the log-rank test. Multivariate Cox proportional hazards modeling was performed using a parsimonious model. Results The mean age was 9.7 ± 4.3 years (range = 3-28), with 40 (71%) males. Most tumors were vermian in location (50, 89.3%) and ≥50 mm in size (38, 67.9%). Gross total resection was achieved in 47 (83.9%) patients. Completion of adjuvant therapy was associated with improved survival (median 23 vs. 4 months; p < 0.0001). Conclusions In this LMIC cohort, completion of postoperative adjuvant therapy (craniospinal radiotherapy followed by chemotherapy) emerged as an important modifiable factor influencing survival. The association between ataxia and improved survival reflects earlier detection rather than biological advantage. Strengthening postoperative radiotherapy compliance and multidisciplinary coordination is essential to improving outcomes.