Retrospective Evaluation of Childhood Central Nervous System Tumors Followed in a Pediatric Hematology Oncology Center: a Single Center Experience

Abstract

Central nervous system (CNS) tumors are one of the main causes of cancer-related deaths in childhood. Although approximately 60% of all patients are alive 5 years after diagnosis, a sequela due to the disease and treatments are common. In this study, we aimed to evaluate the demographic, clinical characteristics, and outcomes of the childhood CNS tumors in our center. A total of 141 patients between 0-18 years who were followed up and completed their treatment in our pediatric oncology center were included. The files were reviewed retrospectively. The median age of patients was 7 years (range 1 month-17.6 years). The male/female ratio was 1.1: 1. The most common presenting symptom was headache. The median time from the first symptom to diagnosis was 1.4 months. Medulloblastoma was the most common diagnosis (n= 28, 19.9%), followed by pilocytic astrocytoma (18.4%, n= 26) respectively. Out of 141 patients, a sequela was seen in 55 (39%) patients. The relationship between high-dose radiotherapy and the development of short stature was statistically significant (p= 0.009). The patients with metastatic disease were likely to have lower survival rates than nonmetastatic disease (p= 0.001). The presence of metastasis increased the death status 6.482 times (OR: 6,482, p= 0.001). The overall 5-year survival rate of all patients was found 80%. There was an association between the histopathological subtypes and overall survival rates (p= 0.001). In the multivariate analysis, metastasis was the most important factor in survival. According to Cox regression analysis, the two most important factors affecting overall survival were the histopathological subtype and the presence of metastasis.