Clinicopathological Analysis of Pediatric Posterior Fossa Tumors: Insights from a National Neurosurgical Center

Abstract

BACKGROUNDː Pediatric posterior fossa tumors are the significant cause of morbidity and mortality in children and adolescents. This study aimed to investigate the characteristics of the patient population and report the experience in managing and treating children with these tumors, as well as their survival outcomes in Kazakhstan. METHODSː This retrospective study analysed data from the archives of the Pediatric Neurosurgery Department and included 214 pediatric patients with PFT in the period from January 2015 to December 2020. RESULTSː The study included 214 patients with a mean age of 7.29 ± 4.26 years. The most common tumor pathology observed in this study was medulloblastoma (33.18%). Grade I tumors showed a notable median survival of 56.64 months (95% CI, 53.93-59.35), surpassing Grade II tumors at 50.38 months (95% CI, 40.57-60.2). Grade III and IV tumors had median survivals of 38.64 months (95% CI, 31.11-46.17) and 38.76 months (95% CI, 33.96-43.56). Multivariate analysis using Cox regression model revealed significant predictors of overall survival. Grade III-IV tumors (RR = 0.577, 95% CI 0.462-0.720, p = 0.000), delayed resection (RR = 0.950, 95% CI 0.717-1.104, p = 0.000), and brainstem tumors (RR = 2.454, 95% CI 1.791-5.751, p = 0.000) had poorer survival. Tumor volume, age, and adjuvant chemotherapy were not significant predictors of 5-year survival (p > 0.05). CONCLUSIONSː The study found similar death rates in children with pilocytic astrocytoma compared to other population studies. Regrettably, the 5-year survival rate for medulloblastoma and ependymoma indicates a poorer outcome compared to previous reports.

Keywords

• pediatric tumor
• posterior fossa tumor
• surgical treatment
• survival