Medulloblastoma (MDB) is the most common malignant cerebellar tumor in children. 
Because of the significant rate of mortality and treatment-related morbidity, 
the identification of prognostic factors could lead to a more accurate selection 
of patients who can benefit from a less aggressive therapy and improve risk 
stratification. Survivin is an inhibitor of apoptosis protein (IAP), the 
expression of which has been associated with worse prognosis in MDB. However, 
both of its subcellular localizations may contribute to tumor progression, and 
ultimately, survivin subcellular localization prognostic value depends on tumor 
type biological features. The goal of this study was to analyze these survivin 
features in the pediatric MDB tumor samples and its impact on clinical outcome. 
Survivin expression and subcellular localization were accessed by 
immunohistochemistry in a series of 41 tumor samples. Kaplan-Meier survival 
curves were compared using the log-rank test. Survivin expression ranged from 
completely absent to fully present in a notably higher pattern of nuclear 
localization than cytoplasmic (19 of 41 versus 4 of 41, respectively). However, 
survivin expression and subcellular localization were not associated with 
five-year overall survival or metastasis status at diagnosis, which was the only 
statistically significant prognostic factor in our series (p = 0.008). Taken 
together, our results suggest that survivin expression should be further studied 
in large, multicenter series to determine its accurate impact on prognosis and 
pathobiology of pediatric MDB.