Pediatric Tumor of Brain, Posterior Fossa Tumors
Conditions
Keywords
Pediatric posterior fossa tumor, Cognitive dysfunction, Cerebellar cognitive affective syndrome, Predictive model, Machine learning, Nomogram, Calibration curve
Brief summary
The goal of this observational study is to develop and validate a clinical prediction model to identify risk factors for long-term cognitive dysfunction in children (ages 0-18 years) who have undergone surgical resection of a posterior fossa tumor. The main questions it aims to answer are: Can a combination of preoperative and postoperative clinical, surgical, and neuroimaging factors accurately predict which children will develop long-term cognitive dysfunction after posterior fossa tumor surgery? Is white matter integrity-specifically fractional anisotropy (FA) of the superior cerebellar peduncle (SCP)-a key independent predictor of cognitive outcomes? Researchers will compare children who developed long-term cognitive dysfunction (cases) to those who did not (controls) to see if differences in imaging biomarkers (e.g., SCP FA, fMRI abnormalities), tumor characteristics (e.g., location, volume, histology), treatment factors (e.g., radiotherapy, surgical approach), and demographic variables (e.g., age) are associated with cognitive outcomes. Participants were not asked to perform any tasks or receive any interventions as part of this study, because it is a retrospective analysis of existing medical records and imaging data. Data collected included: Preoperative and postoperative brain MRI and DTI scans Tumor pathology and surgical reports Treatment details (e.g., radiation, chemotherapy) Neuropsychological assessment results at 1-year follow-up
Interventions
OTHERNot applicable- observational study
Sponsors
West China Hospital
Study design
Observational model
CASE_ONLY
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
No minimum to 18 Years
Healthy volunteers
No
Inclusion criteria
* Age 0-18 years at time of surgery * Histopathologically confirmed primary posterior fossa tumor (e.g., medulloblastoma, ependymoma, pilocytic astrocytoma) * Underwent surgical resection of the tumor at the hospital * Availability of preoperative brain MRI and diffusion tensor imaging (DTI) * Completed standardized neuropsychological assessment at approximately 1 year post-surgery
Exclusion criteria
* Pre-existing neurological or neurodevelopmental disorders (e.g., autism, intellectual disability, cerebral palsy) * History of prior cranial irradiation or chemotherapy before posterior fossa surgery * Incomplete clinical, imaging, or follow-up data required for model variables * Tumor recurrence or progression before 1-year cognitive assessment * Non-posterior fossa primary brain tumors (e.g., supratentorial gliomas)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of Long-Term Cognitive Dysfunction | 1 year | Presence or absence of long-term cognitive dysfunction, defined as a full-scale IQ (FSIQ) score \< 85 or significant impairment in ≥2 cognitive domains (e.g., attention, memory, executive function, processing speed) on standardized neuropsychological assessment at 1-year follow-up. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Model Discrimination Performance | 1 year post-surgery | Area Value under the receiver operating characteristic curve (AUC) of the final predictive model (nomogram) in the internal validation cohort. |
| Model Calibration Accuracy | 1 year after surgery | Agreement degree between predicted probability and observed frequency of cognitive dysfunction, assessed by Hosmer-Lemeshow test P Value. |
Countries
China
Outcome results
None listed