Abstract Background Pediatric central nervous system (CNS) tumors are an important cause of cancer-related mortality in children. In low-income and conflict-affected settings, outcomes remain poor due to delayed diagnosis, limited neurosurgical and radiotherapy capacity, and difficulties with continuity of care. In Yemen, data on pediatric CNS tumors are scarce. This study describes the outcomes of children with CNS tumors treated at a major national cancer center. Methods We performed a retrospective cohort study including children aged 18 years diagnosed with intracranial tumors between 2013 and 2025. Diagnosis was based on histopathology and/or characteristic neuroimaging. Data collected included demographics, tumor histology, extent of surgical resection, chemotherapy and radiotherapy use, major treatment-related complications, and survival status at last follow-up. Descriptive statistics were used, and overall survival was assessed using Kaplan–Meier analysis. Results A total of 139 children with CNS tumors were included, with a slight female predominance. Tumor distribution showed a predominance of aggressive disease: medulloblastoma (∼27%), malignant gliomas (∼21%), astrocytoma (∼10%), ependymoma (∼8%), and glioblastoma (∼5%), while other histologies accounted for approximately 30%. Most patients presented late, often with advanced disease. Access to gross total resection and adjuvant radiotherapy was limited, and multimodal treatment was frequently incomplete due to infrastructure constraints, socioeconomic difficulties, treatment toxicity, and loss to follow-up. Nearly half of patients experienced significant delays or interruptions in care. In line with reports from low-income settings, estimated 3–5-year overall survival ranged from 30–40%, with variation by tumor type and treatment completeness. Conclusions This study provides one of the most comprehensive descriptions of pediatric CNS tumors from Yemen and demonstrates major gaps in neuro-oncology care in a conflict-affected, low-resource setting. Improving early diagnosis, neurosurgical capacity, radiotherapy access, and continuity of care is urgently required. These findings support targeted training, international collaboration, and sustainable capacity-building initiatives to improve pediatric neuro-oncology care in conflict-affected, low-resource settings.
Batis et al. (Tue,) studied this question.
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