Experience of Pediatric Brain Tumor Surgery at the Punjab Institute of Neurosciences, Lahore, Pakistan: A Retrospective Analysis of Outcomes and Challenges
TL;DR
Supratentorial tumors were more common, while infratentorial tumors had higher resection rates and had high VP shunt requirements.
Abstract
Background: Brain tumours are the most prevalent solid cancers in children and are a significant cause of cancer morbidity. However, there is limited information on surgical outcomes in Pakistan, particularly in newly established paediatric neurosurgery units. This study aimed to determine the incidence, clinical features, imaging findings, surgical treatment and prognosis of supratentorial and infratentorial brain tumours in children.Methodology: This was a descriptive retrospective study conducted at the Punjab Institute of Neurosciences from June 2023 to June 2024, including 92 pediatric patients who underwent surgical resection of brain tumours. The clinical presentation, imaging characteristics, surgical interventions, histopathology and outcomes were recorded and evaluated.Results: Among 92 patients, 63% (n = 58) had supratentorial tumors and 37% (n = 34) had infratentorial tumors. Mean ages were 11.34 ± 4.77 years and 10.94 ± 3.78 years, respectively. Out of 92, 46 (50%) were male, and 46 (50%) were female. Headache was the most common presenting symptom in both groups (n = 46 supratentorial (76.3%) and n = 31 infratentorial (91.3%). Supratentorial tumors were most frequently located in the middle cranial fossa (53.4%, n = 31), with gliomas being the predominant histology. Gross-total resection was achieved in 69% (n = 40) of supratentorial cases and 88.3% (n = 30) of infratentorial cases. Ventriculoperitoneal (VP) shunt placement was more commonly required in infratentorial tumors (42.1%, n = 14) compared to supratentorial tumors (6.9%, n = 4). Pilocytic astrocytoma was the most common histology in the infratentorial group. Postoperative Glasgow Coma Scale (GCS) and Lansky Play-Performance Scale (LPPS) scores were comparable between the two groups.Conclusion: Supratentorial tumors were more common, while infratentorial tumors had higher resection rates and had high VP shunt requirements.