ID #385 Pediatric Low-Grade Gliomas; A 12-year retrospective review from a tertiary care hospital in LMIC
Farrah Bashir, Naureen Mushtaq, Mobeen Shahid, Soha Zahid, Shayan Anwar, Bilal Qureshi, Altaf Laghari, Ashir Shafique, Khurram Minhas, Abdul Rehman Abdul Rehman, Eric BouffetAbstract
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.