Outcomes of Congenital Brain Tumors: A Single-Center Experience in a Low- and Middle-Income Country.

Authors

Abrahim Danish Durrani, Muhammad Hayyan Qadri, Mohammad Usman Khan, Ansab Jilani, Yasir Aziz Jaffer, Agha Ahmed Muhammad Hussain, Amna Zainab Khalid, Salaar Ahmed, Hafiza Fatima Aziz, Naureen Mushtaq, Muhammad Shahzad Shamim

Published in

Brain tumor research and treatment. Volume 14. Issue 3. Pages 147-158.

Abstract

Congenital brain tumors (CBTs), defined as intracranial neoplasms initially presented within the first year of life, are rare and biologically heterogeneous, with outcomes largely derived from high-income country data. Evidence from low- and middle-income countries (LMICs) remains sparse, limiting contextual understanding of disease burden and survival.
We conducted a retrospective single-center cohort study of infants with surgically managed intracranial tumors presenting within the first year of life at a tertiary referral center in Pakistan between January 1, 1988, and July 31, 2025. Vascular and metastatic lesions were excluded. Demographic, clinical, radiological, histopathological, operative, and adjuvant-treatment data were extracted from medical records. Tumors were classified according to WHO 2021 nomenclature where feasible. Overall survival was estimated using Kaplan-Meier methods, and factors associated with survival were explored using Firth-penalized Cox regression because of low event counts.
Fifty infants were included; median age at surgery was 420.00 days (interquartile range 198.50-566.00 days), and 26 were male. Supratentorial tumors comprised 20 (40.0%) cases, and 25 (50.0%) were high-grade (WHO grade III-IV). Gross total resection was achieved in 11 (22.0%) patients and subtotal resection in 20 (40.0%). Postoperative complications occurred in 8 (16.0%). Among 33 patients with available survival follow-up, estimated overall survival was 93.9% at 30 days, 82.5% at 6 months, 74.2% at 1 year, and 58.6% at both 5 and 10 years. No clinicopathological variable was independently associated with survival in penalized Cox regression.
In this single-center LMIC cohort, survival after surgical management of CBTs appeared lower than that generally reported in high-income settings. These findings highlight the need for earlier diagnosis, improved access to specialized pediatric neuro-oncology care, and multicenter collaborative studies to better define prognostic determinants and improve outcomes.

PMID:
42543813
Bibliographic data and abstract were imported from PubMed on 03 Aug 2026.

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