title: Pediatric brain tumors in a low/middle income country: does it differ from that in developed world?
abstract: Central nervous system (CNS) tumors are the most frequent solid tumors in children and adolescents. The epidemiology of these tumors differs in areas of the world. However, very little data is available in the low/middle income countries (LMIC). The aim of this study is to describe the characteristics of primary childhood brain tumors treated at a leading LMIC pediatric cancer hospital and its difference from that in other countries. One thousand one hundred fourteen children and adolescent having CNS tumors were treated in the largest pediatric cancer hospital in the Middle East during a period of 5½ years. They were diagnosed histopathologically in 80.2 %, through medical imaging in 19.4 % and via both tumor markers and imaging in the remaining 0.4 % of cases. Through epidemiological analysis was performed using all available patients' data revealed that 96 % of the patients had primary brain tumors, while only 4 % the primary lesion was in the spinal cord. The most common histological type was astrocytic tumor (30.0 %, pilocytic (GI) = 13.2 %, GII = 10.5 % and GIII + IV (high grade) = 6.3 %) followed by embryonal tumor (23.2 %, medulloblastoma = 18.7 %, PNET = 2.8 %, ATRT = 1.5 % and ependymoblastoma = 0.2 %) then ependymoma in 8.7 %, craniopharyngeoma in 5.3 %. The mean age at diagnosis was 7.1 ± 4.2 years which did not differ significantly by gender nor residency but it differed by the pathological subtype. The frequency of each pathological type was different among different age groups. Though the present study was a hospital-based analysis in a low/middle income country, yet it did not differ from the well-established population-based study reports in the high income countries.
authors.affiliation: National Liver Institute, Menoufia University, Al Minufya, Egypt.
authors.forename: Sameera
authors.initials: S
authors.lastname: Ezzat
authors.affiliation: Research Department, Children's Cancer Hospital Egypt (CCHE) and National Cancer Institute, Cairo University, 1 Sekket El Emmam, Sayeda Zainab, Cairo, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Kamal
authors.affiliation: Research Department, Children's Cancer Hospital Egypt (CCHE) and National Cancer Institute, Cairo University, 1 Sekket El Emmam, Sayeda Zainab, Cairo, Egypt.
authors.forename: Nada
authors.initials: N
authors.lastname: El-Khateeb
authors.affiliation: Neurosurgery Department, Cairo University, 1 Sekket El Emmam, Sayeda Zainab, Cairo, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: El-Beltagy
authors.affiliation: Pathology Department, Cairo University, 1 Sekket El Emmam, Sayeda Zainab, Cairo, Egypt.
authors.forename: Hala
authors.initials: H
authors.lastname: Taha
authors.affiliation: Radiology Department, Cairo University, 1 Sekket El Emmam, Sayeda Zainab, Cairo, Egypt.
authors.forename: Amal
authors.initials: A
authors.lastname: Refaat
authors.affiliation: Pediatric Oncology Department, Cairo University, 1 Sekket El Emmam, Sayeda Zainab, Cairo, Egypt.
authors.forename: Madeha
authors.initials: M
authors.lastname: Awad
authors.affiliation: Pediatric Oncology Department, Cairo University, 1 Sekket El Emmam, Sayeda Zainab, Cairo, Egypt.
authors.forename: Sherif
authors.initials: S
authors.lastname: Abouelnaga
authors.affiliation: Radiotherapy Department, Children's Cancer Hospital Egypt (CCHE) and National Cancer Institute, Cairo University, 1 Sekket El Emmam, Sayeda Zainab, Cairo, Egypt. mszagh@yahoo.com.
authors.forename: Mohamed Saad
authors.initials: MS
authors.lastname: Zaghloul
mesh_terms: D000293:Adolescent; D001254:Astrocytoma / Q000453:epidemiology; D001932:Brain Neoplasms / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D003397:Craniopharyngioma / Q000453:epidemiology; D019049:Developed Countries; D003906:Developing Countries; D004806:Ependymoma / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008877:Middle East / Q000453:epidemiology; D009373:Neoplasms, Germ Cell and Embryonal / Q000453:epidemiology*; D012959:Socioeconomic Factors
keywords: Brain; CNS tumors; Children; Epidemiology; Pediatric cancer; Spinal cord