Pediatric Brain tumors in Southeast Nigeria; An 8-year prospective longitudinal cohort study

Abstract Background: Pediatric brain tumors (PBT’s) from previous studies are associated with poor outcomes in our subregion. Methods. An 8 -year single center prospective study. All cases investigated with neuroimaging and treated were enrolled. Data was analyzed with SPSS (Inc) Chicago IL, USA version 23. Chi Square test, One-way Anova and confidence limits were used to evaluate associations using the 95% level of significance. Patients were followed up for a range of 1 to 7.5 years with a mean of 4.9 ±1.3years. Ethical approval was obtained for our study. Results: 95 patients were enrolled, 84 satisfied the study criteria. There were 45 males and 39 females, M: F=1.1. The mean age was 9.9±2.7 years 95%CI with a range of 9 months to 16 years. The most common symptom was headache for supratentorial lesions (73%) and gait disturbance (80.2%) for infratentorial lesions. More tumors were supratentorial in location (45(54.2%), while 33(37.1%) were infratentorial. Craniopharyngiomas (n=19), medulloblastomas(n=17) and astrocytomas (n=11) were the most common tumors. Hemoglobin genotype(AA and AS) had some influence on tumor phenotype, Odds ratio 8.9 and 3.3 for medulloblastoma and craniopharyngioma. 69 cases were microsurgically resected while 14 patients were treated with radiotherapy alone. The 30-day mortality for operated cases is 7.9±1.3%. Overall 1-year and 5-year survival was 67.9% and 53.6 % respectively. Survival rates varied among treatment groups (X2=8.9, P=0.017). Conclusion: Survival profile in this series suggests some improvement in comparison to previous studies from our region.