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Intracranial tumors in children: a 10-year review from a single tertiary health-care center

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Abstract

Objective

Brain tumors are the second most common pediatric malignancy and the most common cause of cancer-related mortality and morbidities. Major advances in terms of surgery, radiation, and chemotherapy have led to better outcomes in developed countries. Delayed diagnosis, advanced disease at presentation, late referrals, nosocomial infections, delays to radiotherapy, and poor support services are the major reasons for poorer outcomes in developing countries. Little is known about the profile of brain tumors in Pakistan. This study aims to evaluate the epidemiology, management, and clinical outcomes of children with brain tumors in Pakistan in a single tertiary care center.

Methods/materials

All children (0–16 years) with primary CNS tumors from 2004 to 2014 at Aga Khan University Hospital were reviewed retrospectively for clinical data, demographics, radiological findings, management, and outcome.

Results

One hundred seventy-five children were included in the study. Male to female ratio was 1.4:1. Most of the patients were in 5–10 years age group (38.9%). Most common presenting complains were headache 115 (65.7%) and vomiting 100 (57.1%). Predominant site was infratentorial 93 (53%). Glial tumors were 105 (60%) followed by embryonal 40(22.9%), craniopharyngiomas 25 (14.3%), and germ cell 1 (0.6%). Astrocytomas (25.7%) were the most common glial tumors while medulloblastoma (15.4%) was the most common embryonal tumor. Majority of the patients underwent surgical resection (78.8%). Radiation was given to 47 (26.8%) patients. A half of the patients, 89 (50%), were lost to follow-up. Forty-two (24%) patients expired, 20 (11.4%) are alive with residual disease while 15 patients (8.5%) were cured with no evidence of recurrence and regular follow-ups.

Conclusion

This is the only study from Pakistan showing demographics of the childhood brain tumors. Significant improvement needs to be made for timely diagnosis, early referrals, and collaborated team efforts with multidisciplinary tumor board to improve outcome.

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Authors and Affiliations

  1. Department of Oncology, Aga Khan University, Karachi, Stadium Road, PO Box 3500, Karachi, 74800, Pakistan

    Quratulain Riaz, Zehra Fadoo & Naureen Mushtaq

  2. Department of Medicine, Aga Khan University, Karachi, Stadium Road, PO Box 3500, Karachi, 74800, Pakistan

    Ehsun Naeem

  3. Specialist Pediatric Haematology/Oncology, Sultan Qaboos University Hospital, Muscat, Oman

    Mahadev Lohano

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  1. Quratulain Riaz
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  2. Ehsun Naeem
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  3. Zehra Fadoo
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  4. Mahadev Lohano
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  5. Naureen Mushtaq
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Correspondence to Quratulain Riaz.

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Riaz, Q., Naeem, E., Fadoo, Z. et al. Intracranial tumors in children: a 10-year review from a single tertiary health-care center. Childs Nerv Syst 35, 2347–2353 (2019). https://doi.org/10.1007/s00381-019-04260-7

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  • DOI: https://doi.org/10.1007/s00381-019-04260-7

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