Infra-Tentorial Brain Tumors – Biological Behavior during First Post-Operative Year – SKIMS, Kashmir Experience

Abstract

Background: To observe the biological behavior like residual disease, progression, recurrence, disabilities, mortality, event free survival (EFS) etc., of histologically different infra-tentorial tumors of in the first postoperative year. Methods: The histopathological records of 410 infra-tentorial tumors out of 589 patients were compared with their clinical outcome up to first postoperative-year in a single-centre, amounting to regional epidemiological-value. In this observational study, retrospectively postoperative records of 589 infra-tentorial tumors of brain from Nov., 1990 to Dec., 2010 (20 years) were retrieved, scrutinized and compiled. The post-operative records of 410 patients with proved histopathological-examination results were included. Statistical law of Variance was applied where-ever necessary.Results: The 63.2% of 410 operated infra-tentorial tumors were males while females predominated in meningiomas and pineoblastomas. About 31.7% infra-tentorial or posterior fossa tumours were children (below-18yrs.). About 54.1% cases were histologically malignant. The residual-tumors comprised 40.2% and symptoms of disease-progression occurred in 10.9%. The tumor recurrence occurred in 14.3% while 6.0% patients developed severe-disability. The overall mortality was 11.4% up to first post-operative year with 18.9% in malignant patients. The first-one-year event-free-survival (EFS) for all the patients was 66.0%. While the patients with malignancies had first-one-year EFS of 47.7%, the histologically benign group had 87.7%. Conclusion: The first one-year postoperative biological behavior like EFS of histologically benign and some malignant infra-tentorial tumors both in children and adults like pilocytic astrocytomas, ependymomas and pineoblastomas was much better (87.7%) than other malignant infra-tentorial tumors.