Pediatric brain tumors in a low/middle income country: does it differ from that in developed world?

Abstract

Central nervous system (CNS) tumors are the most frequent solid tumors in children and adolescents. The epidemiology of these tumors differs in areas of the world. However, very little data is available in the low/middle income countries (LMIC). The aim of this study is to describe the characteristics of primary childhood brain tumors treated at a leading LMIC pediatric cancer hospital and its difference from that in other countries. One thousand one hundred fourteen children and adolescent having CNS tumors were treated in the largest pediatric cancer hospital in the Middle East during a period of 5½ years. They were diagnosed histopathologically in 80.2 %, through medical imaging in 19.4 % and via both tumor markers and imaging in the remaining 0.4 % of cases. Through epidemiological analysis was performed using all available patients' data revealed that 96 % of the patients had primary brain tumors, while only 4 % the primary lesion was in the spinal cord. The most common histological type was astrocytic tumor (30.0 %, pilocytic (GI) = 13.2 %, GII = 10.5 % and GIII + IV (high grade) = 6.3 %) followed by embryonal tumor (23.2 %, medulloblastoma = 18.7 %, PNET = 2.8 %, ATRT = 1.5 % and ependymoblastoma = 0.2 %) then ependymoma in 8.7 %, craniopharyngeoma in 5.3 %. The mean age at diagnosis was 7.1 ± 4.2 years which did not differ significantly by gender nor residency but it differed by the pathological subtype. The frequency of each pathological type was different among different age groups. Though the present study was a hospital-based analysis in a low/middle income country, yet it did not differ from the well-established population-based study reports in the high income countries.

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

“…Several series' report a male predominance in all parts of the CNS [9,11,18,19]. In our series, PCF tumours were slightly more prevalent in males.…”

Barriers and Clinical Factors Influencing Outcomes of Older Children with Medulloblastoma in a Resource Limited Setting - Peru

“…Data collected by the Pan American Health Organization (PAHO) demonstrates that Peru is an example of how advances in health care have decreased mortality due to communicable disease or other preventable diseases while mortality due to malignancy remains relatively unchanged (www.PAHO.org ; Supplemental Figure 1 ). While the survival rates for average risk medulloblastoma are approaching 80-90% in HIC, survival rates in our study, as well as those in other LMIC suggest areas that can be addressed that will allow for improvement in survival rates in pediatric medulloblastoma in Peru 7,8,10,21 . Univariate analysis demonstrated that histologic sub-type, presence of metastasis at diagnosis, and treatment post-2008 all negatively affected outcomes in our study (Table 4 ).…”

Central nervous system tumors: Spotlight on India

“…[6] A 10-microRNA (miRNA) expression signature profiling data of 222 GBM patients were tested, seven of which were risky and three protective RNAs. [7] Patients were divided into different groups based on the high-or low-risk scores which differed significantly in terms of both short-and long-term survival. Similarly, 14 genes GBM prognostic signature used weighted gene score can be used as an independent predictor of survival as shown in 123 patients.…”

“…There have been studies to test the suggestions that there are differences in epidemiological variables, clinical presentation, prognostic factors, and occasional behavior to therapy, when western patients are compared to their Indian counterparts. [5][6][7] As an example, western investigators have documented the presence of the JC viral (JCV) genome in a variety of brain tumors, particularly in medulloblastomas, gliomas, and ependymomas. However, in a study of 22 medulloblastoma patients, JCV antigens could not be detected by immunohistochemistry in the tumor tissues of Indian children with medulloblastomas.…”