Childhood Central Nervous System Tumours in a Major Center in Ghana: Presentation and Outcomes

AIMS To determine presentation, prediagnostic symptomatic interval (PSI), outcomes and quality of life at 12-week follow-up in children aged 1-17 years diagnosed with CNS tumours at Korle Bu Teaching Hospital (KBTH). METHODS This was a hospital-based cross-sectional, correlational study using the PedsQL questionnaire at the initial pre- sentation and 12 weeks after. The study population included all children (aged 1 to 17 years) with a new, ra- diologically diagnosed CNS tumour. and their caregivers attending the Paediatric Oncology and Neurosurgery Units of KBTH. RESULTS The study included 45 children with a median age of 7 years (range 2-17 years) and 56% were males. The most common tumour location was infratentorial (45%) and low-grade gliomas were the most frequent histology (n=23). Common symptoms were headache (n=33), motor abnormalities (n=29) and vomiting (n=24). Two children had Neurofibromatosis type 1. The median diagnostic interval was 121 days (range 44-305 days), with a patient interval of 60 days and a pri- mary healthcare interval of 21 days. Nineteen children (42%) received definitive surgical treatment, with only four children (9%) receiving gross total resection, with a median time to resection of 28.5 days (range 27.5-37 days). Twelve-week survival was 68.9%. There was a strong correlation between caregivers’ and children’s total QOL scores at presentation (r=0.88). At follow-up, children’s self-reports of emotional well-being were lower than caregivers’ assessments. CONCLUSION We have a high rate of mortality at 12 weeks and this needs to be addressed. Children with low-grade tumours experienced longer prediagnostic symptomatic intervals compared to those with high-grade tumours. There was a significant improvement in QOL at 12 weeks, but caregivers underestimated the emotional challenges their children faced. The study emphasizes the need for increased focus on the emotional well-being of children with CNS tumours and their survival.