OTHR-18. Decoding the Intricate Nature of Pediatric Spinal Tumors: A Single-center Retrospective Study on Tumor Characteristics, Therapeutic Strategies, and Outcomes

Background The prognosis for spinal tumors (ST) is frequently grave, carrying risks including sphincter dysfunction, permanent paralysis, and sensory loss. There is remarkably scant data on their occurrence and manifestations in pediatric population. Our research looks on the tumor characteristics, symptoms, management, and outcomes of pediatric ST. Methods We conducted a retrospective review of the Stanford Medicine Research Data Repository (STARR) database between January 1996 till December 2024, examining 58 patients under 18 years of age. Clinical presentations, tumor characteristics, treatments and outcomes for these patients were analyzed. Results Our cohort included 30 (51.7%) females and 28 (48.3%) males, mean age of 8.95 years (median: 9, IQR: [5, 14]). 36 cases (67.9%): intramedullary, 11 (20.8%); extramedullary and 5 (9.4%) were extradural tumors. 19 (32.8%) cases malignant, 35 (60.3%) benign, and 4 (6.9%) were unknown, and with a mean size of 45.2 mm (median: 35.0 mm, IQR: [23.0, 56.0]). Of the 56 cases, 27 (48.2%) underwent R1 resection, 15 (26.8%) R2 resection, and 14 (25%) en-bloc resections. 21 (36.8%) cases had a recurrence. The mean follow-up period was 96.9 months (median: 72, IQR: [29, 158]). 14 (33.3%) cases underwent adjuvant chemotherapy, 15 (37.5%) cases adjuvant radiotherapy and one case, Cyberknife. Kaplan-Meier Curve analysis for the 17 malignant cases showed a predicted survival at 6-months of 0.7334 (95% CI: [0.436-0.890]). 6 (35.3%) among these cases died, and 5 (83.3%) of them, interestingly being intramedullary tumors. This is in contrast to only 11 (64.7%) of the 17 malignant cases being confirmed to be intramedullary tumors. Conclusions Majority of the pediatric STs were intramedullary, and benign. En-bloc resection is the preferred management modality, and often followed by chemoradiotherapy. The malignant cases showed a predicted survival of 0.7334 at 6-months. Pediatric intraspinal tumors, thus presents significant therapeutic hurdles notwithstanding their rarity. The patient’s neurological condition and the disease entity’s interwoven intricacies necessitate the prompt implementation of a personalized treatment plan.