TY - JOUR
T1 - Clinical profile and outcomes of pediatric ependymoma
T2 - a 10-year retrospective analysis from a resource-limited setting
AU - Bashir, Farrah
AU - Hussain, Nowal
AU - Qureshi, Bilal Mazhar
AU - Khandwala, Kumail
AU - Anwar, Shayan Sirat Maheen
AU - Nisar, Fareeha
AU - Enam, Syed Ather
AU - Minhas, Khurram
AU - Mushtaq, Naureen
N1 - Publisher Copyright:
© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2025.
PY - 2025/12
Y1 - 2025/12
N2 - Background: Pediatric ependymomas account for 6–10% of central nervous system tumors in children and are the third most common pediatric brain tumor. However, survival and outcome data from low- and middle-income countries (LMICs), particularly in South Asia, are limited. This study aims to evaluate the clinical profile, treatment approaches, and survival outcomes of pediatric patients with ependymoma in a tertiary care setting in Pakistan. Methods: This retrospective cohort study included 48 pediatric and young adult patients (aged 0–21 years) diagnosed with ependymoma and treated at Aga Khan University Hospital, Karachi, from January 2012 to December 2021. Data were collected on demographics, clinical presentation, tumor location, histopathology, treatment modalities, and follow-up. Survival analysis was conducted using SPSS version 23.0, with Kaplan-Meier estimates for overall survival (OS) and progression-free survival (PFS), and comparisons performed using the log-rank test. Results: Of the 48 patients, 64.6% were male, with a median age of 7.5 years. Presenting symptoms included headache and vomiting (43.75%), limb weakness (25%), back pain (20.83%), and ataxia (18.75%). Tumors were located in the posterior fossa (50%), supratentorial region (29.2%), and spinal cord (20.8%). All patients underwent surgical resection; postoperative complications were noted in a subset. Histopathological subtypes included anaplastic (62.5%), classic (33.3%), and myxopapillary ependymoma (4.2%). Adjuvant radiotherapy was given to 62.5% and chemotherapy to 10.4%. The 10-year overall survival (OS) and progression-free survival (PFS) rates were 79.2% and 66.7%, respectively. Tumor recurrence was observed in 18.8% of cases. Conclusion: Multimodal treatment yielded favorable outcomes despite resource constraints. Early diagnosis and individualized management are crucial for enhancing survival in low- and middle-income country (LMIC) settings.
AB - Background: Pediatric ependymomas account for 6–10% of central nervous system tumors in children and are the third most common pediatric brain tumor. However, survival and outcome data from low- and middle-income countries (LMICs), particularly in South Asia, are limited. This study aims to evaluate the clinical profile, treatment approaches, and survival outcomes of pediatric patients with ependymoma in a tertiary care setting in Pakistan. Methods: This retrospective cohort study included 48 pediatric and young adult patients (aged 0–21 years) diagnosed with ependymoma and treated at Aga Khan University Hospital, Karachi, from January 2012 to December 2021. Data were collected on demographics, clinical presentation, tumor location, histopathology, treatment modalities, and follow-up. Survival analysis was conducted using SPSS version 23.0, with Kaplan-Meier estimates for overall survival (OS) and progression-free survival (PFS), and comparisons performed using the log-rank test. Results: Of the 48 patients, 64.6% were male, with a median age of 7.5 years. Presenting symptoms included headache and vomiting (43.75%), limb weakness (25%), back pain (20.83%), and ataxia (18.75%). Tumors were located in the posterior fossa (50%), supratentorial region (29.2%), and spinal cord (20.8%). All patients underwent surgical resection; postoperative complications were noted in a subset. Histopathological subtypes included anaplastic (62.5%), classic (33.3%), and myxopapillary ependymoma (4.2%). Adjuvant radiotherapy was given to 62.5% and chemotherapy to 10.4%. The 10-year overall survival (OS) and progression-free survival (PFS) rates were 79.2% and 66.7%, respectively. Tumor recurrence was observed in 18.8% of cases. Conclusion: Multimodal treatment yielded favorable outcomes despite resource constraints. Early diagnosis and individualized management are crucial for enhancing survival in low- and middle-income country (LMIC) settings.
KW - Ependymoma
KW - Incidence
KW - LMIC
KW - Outcomes
KW - Resource-limited setting
KW - Tertiary care
UR - https://www.scopus.com/pages/publications/105019659977
U2 - 10.1007/s00381-025-07000-2
DO - 10.1007/s00381-025-07000-2
M3 - Article
AN - SCOPUS:105019659977
SN - 0256-7040
VL - 41
JO - Child's Nervous System
JF - Child's Nervous System
IS - 1
M1 - 330
ER -