ID #600 EXPERIENCE IN THE DIAGNOSIS, TREATMENT, AND OUTCOMES OF CHILDREN WITH CENTRAL NERVOUS SYSTEM TUMORS AT A PEDIATRIC TERTIARY CARE HOSPITAL IN MEXICO

Background

Central nervous system tumors (CNST) are the second leading cause of childhood cancer in Mexico; however, comprehensive national reports describing their clinical course are limited. This study aimed to characterize the diagnosis, treatment, and outcomes of pediatric patients with CNST treated at a tertiary care hospital in Mexico.

Methods

A retrospective, descriptive cohort study was conducted. Medical records of consecutive patients diagnosed and treated for CNST at the Hospital para el Niño from Toluca, Mexico, between January-2012 and December-2025 were reviewed. Demographic, clinical, histopathological, therapeutic, and survival data were analyzed.

Results

Ninety-one patients were included (47 males, 44 females). Median age at diagnosis was 6 years (IQR 4–9). The median time from symptom onset to diagnosis was 65 days (IQR 35–138). The most frequent tumor types were medulloblastoma (n = 23; 25.3%), astrocytoma (n = 22; 24.2%), and pontine glioma (n = 18; 19.8%). At diagnosis, 40 patients (43.9%) had localized disease, 23 (25.2%) metastatic disease, and 28 (30.7%) lacked documented staging. Tumor location was infratentorial in 61 cases (67.0%), supratentorial in 26 (28.5%), and spinal in 4 (4.3%).

Surgical intervention was performed in 67 patients (73.6%): partial resection in 44 (65.6%), complete resection in 7 (10.4%), and biopsy only in 16 (23.8%). Chemotherapy was administered to 55 patients (60.4%) and radiotherapy to 32 (35.1%). During follow-up, 49 patients (53.8%) died, 22 (24.1%) achieved remission, 9 (9.8%) were alive on treatment, 10 (10.9%) abandoned therapy, and 1 (1.1%) was referred to another institution. Five-year overall survival was 34.7% ±12%.

Conclusions

Patients with CNST treated at our institution exhibited low overall survival. A high proportion of pontine gliomas, limited surgical resection, and frequent incomplete staging at diagnosis were observed. These findings suggest structural and technical barriers affecting outcomes and highlight the need to strengthen diagnostic, therapeutic, and staging capabilities in pediatric referral centers.