Abstract Background and objective Central Nervous System (CNS) tumors are the leading solid malignancies in children, Forty percent of CNS tumors in children are glial tumors, with two-thirds of these gliomas being categorized as low-grade gliomas (LGG). We aimed to review the clinical profile, management, and outcomes of pediatric LGG cases. Methodology A retrospective cohort study was conducted at Aga Khan University Hospital between 2013 and 2025 including patients aged ≤18 years diagnosed with LGG. The study included both biopsy-proven and radiologically diagnosed cases. Results A total of 198 patients were identified, comprising mainly male population (52.3%). Median age was 10 years (IQR 6-14) with most common age group being 10–18 years (49.2%). Median duration of symptoms was 4 months (IQR 1-18). Headache (n = 115) and vomiting (n = 95) were the primary presenting complaints. Tumors were predominantly supratentorial (n = 119). The most common histopathology was Pilocytic Astrocytoma (n = 130). Surgery was done in 162 (81.8%) patients; Gross Total Resection (GTR) was achieved in 83 patients (41.7%). Twenty four (14.1%) patients received Chemotherapy while 11 (5.5%) had radiation therapy. Stable disease was in 114 (57.3%) patients while progression and relapse occurred in 37 (18.6%) and 9 (4.5%) patients, respectively. Thirty-nine (19.6%) patients did not have any follow-op scans. The Overall Survival (OS) was 96.5%, with only 7 recorded deaths. Surgery was deferred in 30 patients (15%), a group primarily comprising Subependymal Giant Cell Astrocytomas, Tectal Plate Glioma, and Optic Path Glioma. Six patients were referred to other hospitals. Conclusion Pediatric low-grade gliomas constituted a substantial burden of CNS tumors in our setup. Despite heterogeneity in presentation, histopathology and location, outcomes were comparable to those reported from high-income countries, underscoring the effectiveness of current practices while highlighting the need for improved follow-up and comprehensive outcome reporting in resource-limited settings.
Bashir et al. (Tue,) studied this question.