Descriptive Epidemiology of Childhood Central Nervous System Tumours in Tunisia

Abstract

Introduction: Central nervous system tumours represent 20% of all childhood cancers, and are the second most common group of neoplasms after leukaemias. Objective: To describe epidemiological characteristics of central nervous system tumours in a paediatric Tunisian population. Patients and Methods: A retrospective study of 492 childhood central nervous system tumours operated between 1990 and 2004 was undertaken. We investigated the age-related location, gender distribution and the histology of all tumours, and adopted the latest WHO classification (2007) in grouping all the tumours. Results: There were 488 primary and 4 secondary tumours; 426 (86.6%) were intracranial and 66 (13.4%) were intraspinal. Of the 426 intracranial tumours, 214 (50.24%) were supratentorial and 212 (49.76%) were infratentorial. The median age at diagnosis was 8 years, with a male:female ratio of 1.14:1. Low-grade tumours (WHO I/II) constituted 67.3% of all lesions and the rest (32.7%) were high-grade tumours (WHO III/IV). The most common tumour found in our series was astrocytoma (38%), followed by medulloblastoma (16.2%), then ependymoma (6.9%), cystic tumours (6.3%) and craniopharyngioma (5.3%). The overall 5-year survival rate was 45% with a mean follow-up period of 36 months. Conclusion: In our patient population, the incidence and distribution of central nervous system tumours were similar to those reported in literature. Overall survival rates varied according to tumour location and histopathology.

Childhood Tumors of the Brain: Demographic Pattern over a Ten-Year Period in the Kashmir Valley

“…The median age at diagnosis varies from series to series, with the age group of 5–10 years as the most common one involved [5,16,17]. In our study, we observed that the >10- to 15-year age group was most frequently involved.…”

“…The craniopharyngiomas were of the adamantinomatous type, and all the pituitary tumors were nonfunctioning. When comparing our series with other studies from the Far East (China) [3], Middle East (Syria) [2], Africa (Tunisia) [5], Europe (Germany) [4], North America (USA [6] and Canada [7]), we observed that astrocytomas were the most common tumors in most of the series, except in a series from Syria in which medulloblastoma was the most common tumor reported (table 5; fig. 2).…”

“…Some variation in incidence is due to varying definitions of upper limits of the age of childhood, which varies between 14 and 17 years [2,3,4,5,6,7]. Another factor could be the lack of proper investigations in underdeveloped countries, thus yielding a fake low incidence, as has been observed in a few studies [14,15].…”

“…In our study, we observed that the >10- to 15-year age group was most frequently involved. Males have consistently been reported to be affected more often than females, and this holds true for both childhood and adult brain tumors [2,5,18,19,20]. However, a series from Africa reports a female preponderance regarding childhood brain tumors [21].…”

“…There are several studies on the epidemiology and distribution of brain tumors from Asia [2,3], Europe [4], Africa [5] and North America [6,7] which show different patterns in different regions. No such study is available from India; thus we analyzed brain tumors in pediatric age in the Kashmir Valley, which is a geographically distinct zone stretching over a 200 × 200 mile area in the Himalayan Mountains, and the incidence of various tumors is different from that in the rest of India [8,9].…”