Pediatric Central Nervous System Tumors in Nepal: Retrospective Analysis and Literature Review of Low- and Middle-Income Countries

Azad, Tej D.; Shrestha, Ram Kumar; Vaca, Silvia D; Niyaf, Ali; Pradhananga, Amit B; Sedain, Gopal; Sharma, Mohan Raj; Shilpakar, Sushil Krishna; Grant, Gerald A.

doi:10.1016/j.wneu.2015.07.074

Cited by 17 publications

(20 citation statements)

References 23 publications

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“…We compared the data from various studies from different regions of Asia [ Table 3 ] and the world [ Table 4 ]. [ 1 2 14 15 16 17 18 19 20 21 22 ] Most studies from all over the world including India quote a male predominance in pediatric brain tumors. [ 1 2 3 11 23 ] However, in our series, the incidence was almost equal in both sexes.…”

Section: Discussionmentioning

confidence: 99%

Pediatric intracranial tumors over a 5-year period in a tertiary care center of North Kerala, India: A retrospective analysis

Govindan¹,

Parambil²,

Alapatt³

2018

Asian J Neurosurg

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Background:Pediatric brain tumors are unique in terms of distribution, clinical presentation, pathologic types, management, and prognosis. There are not many studies from India which have looked into the epidemiology of pediatric brain tumors.Aims:This study aimed to analyze the epidemiology of pediatric brain tumors in North Kerala and compare it with data from the rest of India and other countries.Materials and Methods:This is a retrospective study of 5-year data of pediatric brain tumors which were operated in a tertiary referral center in North Kerala, India, from 2009 to 2013. The data were procured from the departments of neurosurgery and pathology of the institution. The data were tabulated and analyzed using SPSS software.Results:A total of 71 children had histologically proven brain tumors during the 5-year period. There were 34 boys and 37 girls. Distribution in different age groups was as follows: infancy –5 (7%), 1–5 years –22 (31%), 6–10 years – 21 (29.6%), and 11–18 years – 23 (32.4%). The most common tumors were primitive neuroectodermal tumors (PNETs). In infancy, the number of high-grade tumors was more, whereas in the 11–18 years’ age group, there were a significantly higher number of low-grade tumors (P = 0.04).Discussion:Pediatric brain tumors were distributed almost equally in both sexes. PNET was the most common. We could not get statistical significance in many of our values due to small sample size.Conclusion:This study highlights the need for diligent collection of data and maintenance of a registry for brain tumors to study the disease in the Indian population.

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Section: Discussionmentioning

confidence: 99%

Pediatric intracranial tumors over a 5-year period in a tertiary care center of North Kerala, India: A retrospective analysis

Govindan¹,

Parambil²,

Alapatt³

2018

Asian J Neurosurg

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“…Astrocytic tumors were the second most common in our study (28.8%) similar to studies from Nepal and Yemen. [ 17 22 ] Interestingly, nearly 17.3% of our CNS tumors were low-grade gliomas whereas pilocytic astrocytoma was the most commonly reported tumor (22.33%) from Europe. [ 25 26 ] Glioblastoma multiforme constituted to only about 3.8% of all tumors as against 17.2% reported in Korea.…”

Section: Discussionmentioning

confidence: 99%

Profile and outcome of pediatric brain tumors – Experience from a tertiary care pediatric oncology unit in South India

et al. 2017

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Context:Tumors of the central nervous system (CNS) constitute the second most common pediatric cancers. Unlike leukemia, management of CNS tumors requires a good multidisciplinary team. Higher rates of treatment abandonment are documented in view of complexity of the treatment with long duration, involving neurosurgery, radiation, chemotherapy, and high cost of treatment. Morbidity associated with CNS tumors may be significant in terms of physical deficits as well as neuropsychological and neuroendocrine sequelae. Pediatric neurooncology is still at a very nascent stage in the developing countries. There are only a few reports on the multidisciplinary approach and outcomes of pediatric brain tumors in developing countries.Aims:The aim of this study is to identify the clinicopathological profile of Pediatric CNS tumors in a tertiary care center located in South India in comparison with reports from other low-and middle-income Countries.Settings and Design:A retrospective analysis of medical records of all children diagnosed with brain tumors from January 2012 to November 2016 at our institute was done.Subjects and Methods:A retrospective study of clinical, pathological profile, and outcomes of children <18 years diagnosed with brain tumors at our institute from January 2012 to November 2016 was done. Histopathological categorization was done as per the WHO classification 2007. The multidisciplinary treatment with respect to surgery, radiation, and chemotherapy was noted and the outcomes were recorded.Statistical Analysis Used:R for Statistical Computing (Version 3.0.2; 2013-09-25).Results:A total of 52 children were diagnosed with male preponderance of 66.6%. Highest incidence was noted in the age group of 0–4 years (50%). Majority of them were supratentorial (59.6%). CNS embryonal tumors contributed to 48% of all our brain tumors. 73% of them underwent either resection or biopsy. Eight (15.3%) of them died due to the progression of disease, but 44% abandoned treatment due to the progression/recurrence of disease. Those lost to follow-up were mostly among the high-risk groups with poor prognosis such as pontine glioma, medulloblastoma (high risk), and primitive neuroectodermal tumor.Conclusions:Although brain tumors constituted 30% of all our solid tumors, only 56% of them received appropriate treatment and 25% abandoned treatment. High rates of abandonment were a consequence of late diagnosis, complex multidisciplinary treatment involved, high treatment cost, lack of uniformity in management between different oncology centers and poor prognosis of the tumor subtype.

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“…Diagnosis of PCF tumours in children is often missed in their early presentation, and a child may go through several investigations before the tumour is finally diagnosed. The theme of delayed presentation in children with brain tumours was reported in studies of other low-and middle-income countries (LMICs) [15,16].…”

Section: Discussionmentioning

confidence: 92%

“…In the majority of published series, astrocytomas are the commonest brain tumours of childhood [7,11,15,18] with cerebellar astrocytoma's being the most frequently occurring PCF tumours in children, accounting for approximately 35% of these lesions [20]. Medulloblastoma accounts for approximately 30% of all brain tumours in children [21].…”

Section: Discussionmentioning

confidence: 99%

Posterior cranial fossa tumours in children at National Cancer Institute, Sudan: a single institution experience

Elhassan

Osman²,

Parkes

2017

Childs Nerv Syst

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Pediatric Central Nervous System Tumors in Nepal: Retrospective Analysis and Literature Review of Low- and Middle-Income Countries

Cited by 17 publications

References 23 publications

Pediatric intracranial tumors over a 5-year period in a tertiary care center of North Kerala, India: A retrospective analysis

Pediatric intracranial tumors over a 5-year period in a tertiary care center of North Kerala, India: A retrospective analysis

Profile and outcome of pediatric brain tumors – Experience from a tertiary care pediatric oncology unit in South India

Posterior cranial fossa tumours in children at National Cancer Institute, Sudan: a single institution experience

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