Patient demographics and baseline characteristics
Patient characteristics are detailed in Table 2 andFigure 1 demonstrates place of birth of the patients. Between January 1997 and December 2013, there were 89 patients diagnosed with medulloblastoma that were included in this study with nearly half of the patients originated from Lima (n=43, 48%, Figure 1). The median age was 8.1 years (range: 2.9-13.9 years) with a male: female ratio was 1.62:1. The most common presenting symptoms at presentation were headache (96%), ataxia (88%), and nausea/vomiting (87%). Details regarding histology were available in 45/89 patients. Of these 45 patients, histologic subtypes included classic medulloblastoma (n= 21, 47%), desmoplastic/extensive nodularity (n=13, 29%), and large cell/anaplastic subtypes (n=11, 24%). Cases of unclassified medulloblastoma occurred almost entirely prior to 2008. Due to an increased availability of MRI and/or CSF examination for patients who were treated post-2008 (n=38) there are additional details on risk stratification and metastatic stage. While 20 (52%) of post-2008 patients presented without evidence of metastatic disease, the majority of non-metastatic patients were defined as high-risk due to presence of large residual tumor (n=12, 60%).