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Paediatric brain tumours in Singapore: A 15-year epidemiological and outcome study
Sherry J Liu1, Natalie M Y Aw2, Mervyn J R Lim1
1Division of Neurosurgery, Department of Surgery, National University Health System, Singapore.
Insights
This study analyzed paediatric brain tumour (PBT) epidemiology in Singapore, finding astrocytic and embryonal tumours most common. Survival rates were comparable to international centres, though certain tumour types and treatments impacted outcomes.
Area of Science:
- Neuro-oncology
- Paediatric Neurosurgery
- Epidemiology
Background:
- Paediatric brain tumours (PBTs) are the most common childhood solid tumours, with reported global variations in incidence and histology.
- Limited epidemiological data exists for PBTs specifically within the Singaporean population.
Purpose of the Study:
- To summarise the epidemiology of paediatric brain tumours managed in Singapore.
- To analyse patient demographics, tumour characteristics, presenting complaints, treatment modalities, and survival outcomes.
Main Methods:
- Retrospective study of paediatric patients (<19 years) diagnosed with PBTs.
- Data collected from KK Women's and Children's Hospital (KKH) and National University Hospital (NUH) between 2002-2017.
- Analysis included age, gender, tumour histology, location, treatment, and overall survival (OS) at 1 and 5 years.
Main Results:
- 396 patients were included; mean age 7.05 years, male-to-female ratio 1.41:1.
- Most common histological groups: astrocytic (30.6%), embryonal (26.0%), germ cell (11.1%).
- 1-year OS was 89.5%, 5-year OS was 72.2%. Poorer 5-year OS observed for embryonal tumours, ependymomas, supratentorial tumours, and patients receiving radiotherapy.
Conclusions:
- Singaporean paediatric brain tumour demographics and outcomes are comparable to international centres.
- Embryonal tumours and ependymomas showed significantly poorer 5-year survival.
- Further research into factors influencing survival for specific PBT subtypes is warranted.
Abstract:
Paediatric brain tumours (PBTs) are the most common solid tumours in children. Previous publications reflect variations in incidence rates and frequency of histological types in different global populations. However, there are limited studies on the epidemiology of PBTs in Singapore. This study aims to summarise the epidemiology of paediatric brain tumours managed in Singapore. This is an ethics-approved retrospective study of all patients below 19 years old diagnosed with PBTs managed by Singapore's 2 tertiary paediatric neurosurgical centres, KK Women's and Children's Hospital (KKH) and the National University Hospital (NUH) over a 15-year period from 01 January 2002 to 31 December 2017. Data collected was analysed for age, gender, tumour characteristics, presenting complaints, location, treatment modalities, 1-year and 5-year overall survival (OS). A total of 396 patients were included. The mean age of diagnosis was 7.05 years (0.25-18; ± 4.83) and male-to-female ratio was 1.41:1. Top histological groups were astrocytic (30.6%), embryonal (26.0%), germ cell (11.1%), ependymoma (30, 7.58%) and craniopharyngioma (27, 6.82%). Outcomes included recurrence rate (31.2%), 1-year OS (89.5%) and 5-year OS (72.2%). Poorer 5-year OS were noted in embryonal tumours (47.0%; p < 0.001) and ependymoma (50.0%; p = 0.0074) patients. Of note, the following cohorts also had poorer OS at 5 years: supratentorial tumours (76.2%; p = 0.0426), radiotherapy (67.4%; p = 0.0467) and surgery (74.9%, HR; p < 0.001). Overall, our data reflects patient demographics, presenting complaints, treatment modalities and survival outcomes, that are comparable to other international paediatric neurosurgical centres.
