Epidemiological analysis of central nervous system tumors in pediatric patients from a tertiary care centre in India
DOI:
https://doi.org/10.18203/2349-3291.ijcp20194724Keywords:
Headache, Infratentorial, Supratentorial, Tumor grade, Paediatric brain tumorsAbstract
Background: Tumors of the nervous system are the second most common childhood cancer after leukemia. The diagnosis of CNS tumors is challenging due to non-specific symptoms in children which mimic other less serious illness.
Methods: This was a retrospective analysis of case records of patients from 0-18 years of age, who were diagnosed with CNS tumors for a period of 7 years.
Results: Out of total 64 patients included in this study, 32 were females and 24 were males. The mean age was 13.2 years. The most common clinical presentation in patients with brain tumors was headache (92.3%) followed by visual symptoms in the form of blurring or loss of vision (42.3%) and swaying while walking (32.6%). The overall mean symptom interval for all patients was 274.8 days (approx. 9 months) ranging from 7-1820 days. In the present study out of total 64 patients, 54 were brain tumors (35 supratentorial and 19 infratentorial) and 10 were spinal tumors. The most common tumor location was cerebellum (21.8%) followed by cerebral cortex, spine and sellar area. Based on histopathology the most common tumor type in our study was astrocytoma. There was no significant correlation of symptom interval with age and gender but was significantly associated with location and tumor grade.
Conclusions: Early referral to centers with appropriate facilities will help, as many pediatric CNS tumors are low grade with better survival.
References
Rosemberg S, Fujiwara D. Epidemiology of pediatric tumors of the nervous system according to the WHO 2000 classification: a report of 1,195 cases from a single institution. Child Nerv Sys. 2005;21(11):940-4.
Gjerris F. Clinical aspects and long‐term prognosis of intracranial tumours in infancy and childhood. Develop Medi Child Neurol. 1976;18(2):145-59.
Mehrazin M, Rahmat H, Yavari P. Epidemiology of primary intracranial tumors in Iran, 1978-2003. Asi Pac J Can Prevent. 2006;7(2):283.
Madhavan R, Kannabiran BP, Nithya AM, Kani J, Balasubramaniam P, Shanmugakumar S. Pediatric brain tumors: An analysis of 5 years of data from a tertiary cancer care center, India. Ind J can. 2016;53(4):562.
Peris-Bonet R, Martínez-García C, Lacour B, Petrovich S, Giner-Ripoll B, Navajas A, et al. Childhood central nervous system tumours-incidence and survival in Europe (1978-1997): report from Automated Childhood Cancer Information System project. Eur J can. 2006;42(13):2064-80.
Cho KT, Wang KC, Kim SK, Shin SH, Chi JG, Cho BK. Pediatric brain tumors: statistics of SNUH, Korea (1959-2000). Child Nerv Sys. 2002;18(1-2):30-7.
Kaatsch P, Rickert CH, Kühl J, Schüz J, Michaelis J. Population‐based epidemiologic data on brain tumors in German children. Cancer: Int Int J Am Can Soci. 2001;92(12):3155-64.
Kaderali Z, Lamberti-Pasculli M, Rutka JT. The changing epidemiology of paediatric brain tumours: a review from the Hospital for Sick Children. Child's Nerv Sys. 2009;25(7):787-93.
Hjalmars U, Kulldorff M, Wahlqvist Y, Lannering B. Increased incidence rates but no space‑time clustering of childhood astrocytoma in Sweden, 1973‑1992: A population‑based study of pediatric brain tumors. Canc. 1999;85(9):2077‑90.
Karkouri M, Zafad S, Khattab M, Benjaafar N, El Kacemi H, Sefiani S, et al. Epidemiologic profile of pediatric brain tumors in Morocco. Childs Nerv Syst. 2010;26(8):1021-7.
Suh YL, Koo H, Kim TS, Chi JG, Park SH, Khang SK, et al. Tumors of the central nervous system in Korea: A multicenter study of 3221 cases. J Neurooncol. 2002;56(3):251-9.
Zhou D, Zhang Y, Liu H, Luo S, Luo L, Dai K. Epidemiology of nervous system tumors in children: A survey of 1,485 cases in Beijing Tiantan hospital from 2001 to 2005. Pediatr Neurosurg. 2008;44:97‑103.
Makino K, Nakamura H, Yano S, Kuratsu J; Kumamoto Brain Tumor Group. Population‑based epidemiological study of primary intracranial tumors in childhood. Childs Nerv Syst. 2010;26:1029‑34.
Jain A, Sharma MC, Suri V, Kale SS, Mahapatra AK, Tatke M, et al. Spectrum of pediatric brain tumors in India: A multi-institutional study. Neurol Ind. 2011;59(2):208-11.
Suresh SG, Srinivasan A, Scott JX, Rao SM, Chidambaram B, Chandrasekar S. Profile and outcome of pediatric brain tumors - Experience from a tertiary care pediatric oncology unit in South India. J Pediatr Neurosci. 2017;12(3):237-44.
Shah HC, Ubhale BP, Shah JK. Demographic and histopathologic profile of pediatric brain tumors: A hospital-based study. South Asian J Cancer. 2015;4(3):146-8.
Margam S, Gadgil NM, Kshirsagar GR, Gaikwad VP, Kumavat PV, Chaudhari CS. The histopathological and epidemiological study of pediatric brain tumors in a Tertiary Care Hospital, Mumbai. Annals of Pathology and Laboratory Medicine. 2016 Nov 6;3(5):A374-381.
Nasir S, Jamila B, Khaleeq S. A retrospective study of primary brain tumors in children under 14 years of age at PIMS, Islamabad. Asian Pac J Cancer Prev. 2010;11(5):1225‑7.
Rickert CH, Paulus W. Epidemiology of central nervous system tumors in childhood and adolescence based on the new WHO classification. Childs Nerv Syst. 2001;17(9):503‑11.
Katchy KC, Alexander S, Al-Nashmi NM, Al-Ramadan A. Epidemiology of primary brain tumors in childhood and adolescence in Kuwait. Springerplus. 2013 Dec 1;2(1):58.
Kaatsch P, Rickert CH, Kühl J, Schüz J, Michaelis J. Population-based epidemiologic data on brain tumors in German children. Canc. 2001;92(12):3155-64.
Flores LE, Williams DL, Bell BA, O'Brien M, Ragab AH. Delay in the diagnosis of pediatric brain tumors. Am J Dis Child. 1986 Jul 1;140(7):684-6.
Edgeworth J, Bullock P, Bailey A, et al. Why are brain tumours still being missed? Arch Dis Child. 1996;74(2):148-51.
Dobrovoljac M, Hengartner H, Boltshauser E, Grotzer MA. Delay in the diagnosis of paediatric brain tumours. Eur J Pediatr. 2002;161(12):666-7.
Mehta V, Chapman A, McNeely P D. et al. Latency between symptom onset and diagnosis of pediatric brain tumors: an Eastern Canadian geographic study. Neurosurg. 2002;51(2:)365-72.
Wilne SH, Ferris RC, Nathwani A, Kennedy CR. The presenting features of brain tumours: a review of 200 cases. Arch Dis Child. 2006;91(6):502-6.
Reulecke BC, Erker CG, Fiedler BJ, Niederstadt TU, Kurlemann G. Brain Tumors in Children: Initial Symptoms and Their Influence on the Time Span Between Symptom Onset and Diagnosis. J Child Neurol. 2008;23(2):178-83.
Kumar LP, Deepa SF, Moinca I, Suresh P, Naidu KV. Medulloblastoma: A common pediatric tumor: Prognostic factors and predictors of outcome. Asian J Neurosurg. 2015;10(1):50.