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Supratentorial Brain Tumors in Infants: Symptomatology, Management, and Postoperative Outcomes
Ryszard Sordyl1, Natalia Wyroba1, Natalia Kardas1
1Department of Pediatric Neurosurgery, Upper Silesian Children's Care Health Center in Katowice, Medical University of Silesia, Katowice, Poland.
Insights
Infants with supratentorial brain tumors often show late symptoms. High-grade tumors impact survival and complete resection success in pediatric neurosurgery.
Area of Science:
- Pediatric Neurosurgery
- Pediatric Oncology
- Neuro-oncology
Background:
- Infantile brain tumors are a significant cause of morbidity and mortality in young children.
- Early diagnosis and effective treatment are crucial for improving outcomes in pediatric neuro-oncology.
- Supratentorial brain tumors in infants present unique diagnostic and therapeutic challenges.
Purpose of the Study:
- To analyze institutional experience in diagnosing and treating infantile brain tumors.
- To evaluate the surgical outcomes and prognostic factors for supratentorial brain tumors in infants.
- To identify associations between tumor grade, resection extent, and patient survival.
Main Methods:
- Retrospective review of medical records for infants (≤1 year) with supratentorial brain tumors (2002-2024).
- Analysis included indications for resection, surgical outcomes, histopathology, and survival data.
- Statistical methods included Kaplan-Meier survival analysis and Cox regression models.
Main Results:
- 34 infants were included; 65% presented with signs of increased intracranial pressure (ICP).
- Choroid plexus tumors were most common (38%). Gross total resection was achieved in 58% of cases.
- High-grade tumors correlated with incomplete resection and poorer prognosis (5-year survival 63% vs. 100% for low-grade).
Conclusions:
- Infantile supratentorial tumors often present with late, non-specific symptoms, frequently related to increased ICP.
- Maximal safe resection is the surgical goal, but complete removal may require multiple procedures.
- Tumor grade is a significant prognostic factor impacting survival in this pediatric population.
Objective:
This study aims to present and analyze the institutional experience in the diagnosis, treatment, and postoperative outcomes of infantile brain tumors.
Methods:
A retrospective review was conducted of medical records of infants (aged ≤ 1 year) who underwent initial surgical treatment of supratentorial brain tumors between 2002 and 2024. Indications for tumor resection included mass effect, symptomatic lesions (e.g., increased intracranial pressure [ICP] or focal deficits), or radiologically confirmed tumor progression. Continuous data were summarized as medians or means and categorical variables as counts and percentages. Survival analyses were performed using the Kaplan-Meier method with log-rank testing, while Cox regression, logistic models, and Fisher's exact test assessed prognostic and functional associations (P < 0.05, Jamovi v2.6).
Results:
Our analysis included 34 infants. Signs of ICP were observed in 65% of patients. Tumors were predominantly intraventricular (38%), with choroid plexus tumors being the most common (38%). The median follow-up was 48 months. Gross total resection was achieved in 58% of initial resections, while high-grade histopathology was independently correlated with incomplete tumor removal (P = 0.016). Additionally, high-grade tumors were also associated with poorer prognosis, with a 5-year overall survival of 63% compared to 100% for low-grade tumors.
Conclusions:
In our institutional experience, infants with supratentorial tumors often presented with late, nonspecific symptoms related to increased ICP. Surgical treatment focused on maximal safe resection, although complete removal was not always feasible in a single procedure.
