Epidemiology, Clinical Presentation, and Prognosis of Pediatric Brain Tumors: Experience of National Center for Children’s Health

Abstract

Objective Brain tumors have become the most common solid tumors in children. The epidemiology is poorly described in China. This retrospective study aimed to describe the epidemiologic characteristics, clinical presentation, and prognosis in national health center for children. Method From January 2015 to December 2020, 484 cases age 0-18 years old diagnosed with brain tumors and receiving neurosurgery treatment were enrolled into the database. Pathology was based on the World Health Organization 2012 nervous system tumor classification, and tumor behavior were classified on International Classification of Diseases for Oncology, third edition. A descriptive and comparative statistic was performed on clinical manifestation, symptom duration, sex, age, tumor location, tumor behavior, and survival time. Results Among the 484 brain tumors, the median age at diagnosis was 4.62 [2.19, 8.17] years old (4.07 [1.64, 7.13] for benign tumors and 5.36 [2.78, 8.84] for malignant tumors). The overall male to female ratios were 1.33:1, with 1.09:1 and 1.62:1 for benign and malignant tumors respectively. Nausea and vomiting, headache were the most frequent initial symptoms. The median symptoms duration was 4[2, 21] weeks. The three most frequent tumor type were embryonal tumors (22.45%), other astrocytic tumors (20.17%), and diffuse astrocytic tumors (11.02%). Supratentorial tumors comprise 57.38% of all brain tumors. And the most common tumor locations were cerebellum and forth ventricles (38.67%), sellar region (22.87%) and ventricles (10.60%). Male were more common among choroid plexus tumors (63.64%), embryonal tumors (61.11%), ependymal tumors (68.57%), and germ cell tumors (78.13%). Patients were followed for 1 to 82 months. The overall 5-year survival was 77.4%, with 90.0% for benign tumor and 65.3% for malignant tumors. log-rank test found significant different at p <0.001 level. Conclusion Brain tumors presented particularly sexual, age dependent, and regional dependent epidemiological characteristic. Our results were consistent with previous reports, and might reflect the real epidemiology status in China.