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Primary Pediatric Brain Tumors in a Tertiary Referral Center in Iran: A 13-Year Retrospective Analysis
Ghazaleh Kheiri1, Sadra Kheiri2, Milad Shafizadeh3
1Department of Neurosurgery, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
Insights
This study analyzed pediatric brain tumors in Iran, finding pilocytic astrocytoma most common. The findings highlight the need for national registries to improve data collection for childhood brain cancer.
Area of Science:
- Pediatric Neuro-Oncology
- Childhood Cancer Epidemiology
- Tumor Histopathology
Background:
- Pediatric central nervous system (CNS) tumors are a significant cause of childhood cancer mortality.
- Understanding the histopathological spectrum is crucial for effective treatment and research.
Purpose of the Study:
- To describe the histopathological spectrum of primary pediatric brain tumors.
- To analyze tumor characteristics and temporal trends over 13 years in a tertiary referral center in Iran.
Main Methods:
- Retrospective review of medical records for 549 pediatric patients (0-17 years) undergoing brain tumor surgery (2008-2020).
- Extraction of tumor histology, location, World Health Organization (WHO) grade, patient age, and sex.
- Descriptive, comparative, and Poisson regression analyses for temporal trends.
Main Results:
- Pilocytic astrocytoma (20.9%) was the most frequent tumor, followed by medulloblastoma (15.3%) and ependymoma (11.3%).
- Tumors were equally distributed in supratentorial and infratentorial regions; low-grade tumors were most common overall.
- A significant increase in pediatric brain tumor surgeries was observed over the study period (IRR: 1.127/year).
Conclusions:
- This study offers institutional insights into pediatric brain tumor characteristics in Iran.
- The prevalence of low-grade tumors underscores the importance of national pediatric neuro-oncology registries.
- Improved data collection is vital for resource allocation and planning, especially in low- and middle-income countries.
Background:
Pediatric central nervous system (CNS) tumors are among the most common childhood malignancies and a leading cause of cancer-related death. This study aimed to describe the histopathological spectrum of primary brain tumors in children over a 13-year period in a tertiary referral center in Iran.
Methods:
In this existing data study (EDS), we reviewed the medical records of 549 patients aged 0-17 years who underwent surgical resection of brain tumors between 2008 and 2020. Tumor characteristics, including histology, location, and World Health Organization (WHO 2016) grade, along with patient age and sex, were extracted. Descriptive and comparative analyses were conducted. Temporal trends for single-center in the number of pediatric brain tumor surgeries performed in our center were assessed using Poisson regression.
Results:
The mean age at diagnosis was 5.1 years, with a male-to-female ratio of 1.3:1. Pilocytic astrocytoma (20.9%) was the most common tumor, followed by medulloblastoma (15.3%) and ependymoma (11.3%). Tumors were nearly evenly distributed between supratentorial (48.6%) and infratentorial (48.5%) regions. Grade I tumors were most frequent overall, while Grade IV tumors were significantly more common in the infratentorial space (P<0.001). No significant differences in tumor distribution were observed by sex or age group. The number of surgeries increased significantly over time (incidence rate ratio: 1.127/year, P<0.001), with no subgroup differences in temporal trend.
Conclusion:
This single-center study provides institutional-level insights into the histopathological characteristics of pediatric brain tumors. The predominance of low-grade tumors observed emphasizes the need for national pediatric neuro-oncology registries, particularly in low- and middle-income countries, to enable more representative data collection and planning.
