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Time to diagnosis and clinical characteristics in pediatric brain tumor patients
Koji Hirata1, Ai Muroi2, Takao Tsurubuchi1
1Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Ibaraki, Japan.
Insights
Pediatric brain tumors, particularly germinomas, often have delayed diagnoses. Symptoms like endocrine or visual disturbances significantly prolong the time to diagnosis, impacting treatment and quality of life.
Area of Science:
- Pediatric Oncology
- Neurology
- Medical Diagnostics
Background:
- Timely diagnosis of pediatric brain tumors is crucial for effective treatment and improved patient outcomes.
- Factors influencing diagnostic delays in pediatric brain tumors require further investigation to optimize clinical pathways.
Purpose of the Study:
- To identify factors contributing to diagnostic delays in pediatric brain tumors.
- To examine the relationship between time to diagnosis and clinical outcomes in pediatric brain tumor patients.
Main Methods:
- A retrospective study was conducted at the University of Tsukuba Hospital, analyzing data from 85 pediatric patients diagnosed with brain tumors over seven years.
- Data collected included intervals from symptom onset to first presentation and from first presentation to diagnosis.
Main Results:
- The median interval from symptom onset to diagnosis was 45 days. Germinoma cases exhibited the longest diagnostic delays.
- Patients presenting with endocrine disorders or visual disturbances experienced significantly longer intervals from symptom onset to diagnosis and from first presentation to diagnosis.
Conclusions:
- Pediatric brain tumors, especially germinomas with endocrine or visual symptoms, face diagnostic delays.
- While direct links to prognosis are unclear, early diagnosis is vital for optimizing treatment and enhancing quality of life, necessitating thorough medical history and prompt neuroimaging.
Purpose:
We aimed to identify factors that affect the time to diagnosis in pediatric brain tumors and investigate the effect of time to diagnosis on clinical outcome.
Methods:
A retrospective study of children with brain tumors aged less than 18 years diagnosed at the University of Tsukuba Hospital over a period of 7 years was conducted.
Results:
Eighty-five consecutive patients, with a mean age of 9.1 years, were included in the study. The median interval from symptom onset to diagnosis was 45 days (range 0-1673); median interval from symptom onset to first presentation was 31.0 days; and median interval from first presentation to diagnosis was 13.5 days. Germinoma had the longest interval from symptom onset to first presentation, and from first presentation to diagnosis. Patients presenting with endocrine disorder had a significantly longer interval from symptom onset to first presentation (p = 0.019); those with visual disturbance (p = 0.016) or endocrine disorder (p = 0.030) had significantly longer intervals from first presentation to diagnosis.
Conclusion:
Pediatric brain tumor patients with germinoma and presenting symptoms of endocrine disorder or visual disturbance have a longer time to diagnosis. Although improved prognosis is not clearly related to a shorter time to diagnosis, we believe that early diagnosis can lead to improved treatment and better quality of life. A detailed medical history and neuroimaging studies at the earliest time possible are important for early diagnosis.
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