Introduction
Authors | Year published | Type of study | Population (time period) | Cohort size (age range in years) | Mean PSI | Median PSI |
---|---|---|---|---|---|---|
Reulecke et al. [13] | 2008 | Single center | Germany (1980–2004) | 245 (0–19.2) | 59.3 days | 24 days |
Hayashi et al. [14] | 2010 | Multi-center | Japan (1995–2008) | 60 (1–15) | Not reported | 20.5 days |
Wilne et al. [15] | 2012 | Multi-center | UK (2004–2006) | 139 (29 days–16.7 years) | Not reported | 3.3 months |
Shay et al. [16] | 2015 | Single center | Israel (1996–2004) | 330 (0–18) | 7.7 months | Not reported |
Stocco et al. [17] | 2017 | Single center | Italy (2000–2012) | 75 (0–16) | Not reported | 4 weeks |
Azizi et al. [18] | 2017 | Single center | Austria (2008–2013) | 212 (0–19) | Not reported | 60 days |
Boutaher et al. [19] | 2018 | Single center | Morocco 2016 | 27 (1–15) | Not reported | 2 months |
Gilli et al. [20] | 2019 | Single center | Brazil (2005–2010) | 192 (0–18) | Not reported | 48 days |
Patel et al. [21] | 2019 | Single center | USA (2008–2017) | 235 (0–25) | Not reported | 42 days |
Hirata et al. [22] | 2020 | Single center | Japan (1984–2000) | 85 (0–18) | Not reported | 45 days |
Materials and methods
Statistical analysis
Results
Characteristic | Number (%) |
---|---|
Total Patients | 51 (100) |
Median age (range) | 45 months (1–171) |
Up to 3 years | 20 (39.2) |
3 to 10 years | 22 (43.1) |
Above 10 years | 9 (17.6) |
Gender | |
Male | 26 (50.9) |
Female | 25 (49.1) |
Nationality | |
Qatari Nationals | 18 (35.3) |
Non-Qatari Nationals | 33 (64.7) |
Neurocutaneous syndromes | |
Neurofibromatosis type 1 | 3 (5.6) |
Tuberous sclerosis | 6 (11.8) |
None | 42 (82.4) |
Tumor location | |
Supratentorial | 30 (58.8) |
Infratentorial | 17 (33.3) |
Spinal | 4 (7.8) |
Tumor type | |
LGG | 24 (47.05) |
Medulloblastoma/PNET | 12 (23.5) |
Germ cell tumor | 5(9.8) |
HGG | 4 (7.8) |
CNS ATRT | 2 (3.9) |
Others | 4 (7.8) |
Localized/metastatic | |
Localized | 42 (82.4) |
Metastatic/multifocal | 9 (17.6) |
Intracranial pressure (ICP) | |
Normal | 28 (54.9) |
Raised | 19 (37.3) |
Data not available | 4 (7.8) |
ED vs. elective diagnosis | |
ED | 27 (52.9) |
Elective | 24 (47.1) |
Tumor characteristics
Referral pathways
Elective referrals (24) | Diagnosed through ED (27) | ||
---|---|---|---|
Prior HC contact | Yes (24) | Yes (14) | No (13) |
Median PSI (days) | 33.5 | 19.0 | |
39.5 | 14.0 | ||
Tumor grade | |||
High grade (%) | 3 (12.5) | 7 (50) | 9 (69.2) |
Low grade (%) | 21 (87.5) | 7 (50) | 4 (30.8) |
Breakdown of prior HC contact | Neuro: 12 Gen Peds, Neuro, Ophth: 2 PCHC: 3 Gen Peds, Endo: 1 Gen Peds, Neuro, Gastro: 1 Gen Peds, Neuro, Endo: 1 Gen Peds, Ophth: 1 Neuro, Cardio: 1 Ophth: 1 NS: 1 | PCHC: 5 PEC: 5 Gen Peds, Endo: 2 Endo: 1 Neuro: 1 |
Presenting symptoms
Symptom progression
Pre-diagnosis symptom interval
Variable | No. of cases (%) | Mean (95% CI1) | Median days | p valuea |
---|---|---|---|---|
Age | ||||
Up to 3 years | 22 (43.14) | 85.50 (24.25–156.04) | 13.50 | 0.594 |
Above 3 years | 29 (56.86) | 117.83 (58.34–188.68) | 36.00 | |
Sex | ||||
Male | 26 (50.98) | 98.19 (52.55–157.06) | 26.50 | 0.838 |
Female | 25 (49.02) | 109.80 (31.70–189.86) | 29.00 | |
Nationality | ||||
Qatari Nationals | 18 (35.29) | 84.39 (27.48–176.35) | 22.50 | 0.589 |
Non-Qatari Nationals | 33 (64.71) | 114.52 (57.17–183.70) | 29.00 | |
ED vs. elective diagnosis | ||||
ED | 27 (52.94) | 54.78 (30.75–83.52) | 19.00 | 0.113 |
Elective | 24 (47.06) | 159.13 (62.18–278.60) | 33.50 | |
Tumor location | ||||
Supratentorial | 30 (58.82) | 148.07 (70.78–244.70) | 39.50 | 0.049 |
Infratentorial | 21 (41.18) | 40.76 (19.21–69.74) | 15.00 | |
Tumor grade | ||||
Low-grade tumor | 32 (62.75) | 148.03 (79.57–223.46) | 45.00 | 0.040 |
High-grade tumor | 19 (37.25) | 29.53 (16.76–43.00) | 15.00 | |
Localized vs. metastatic | ||||
Localized | 42 (82.35) | 82.29 (40.24–140.91) | 26.50 | 0.230 |
Metastatic | 9 (17.65) | 204.67 (53.14–396.00) | 90.00 | |
Intracranial pressure (ICP)2 | ||||
Raised | 28 (59.57) | 56.89 (33.47–85.04) | 24.00 | 0.077 |
Normal | 19 (40.43) | 191.21 (82.40–331.04) | 51.00 |
Symptom | No. of cases (%) | Mean days (95% CI1) | Median days (days) | p valuea |
---|---|---|---|---|
Headache | 19 (37.25) | 93.68 (35.86–165.56) | 19.00 | 0.793 |
Vomiting | 17 (33.33) | 82.00 (18.01–169.64) | 14.00 | 0.585 |
Irritability | 7 (13.73) | 124.86 (3.42–394.55) | 8.00 | 0.842 |
Oculo-visual | 9 (17.65) | 204.00 (26.34–417.87) | 36.00 | 0.282 |
Ataxia | 9 (17.65) | 30.78 (11.70–53.58) | 19.00 | 0.039 |
Developmental delay | 2 (3.92) | 455.50 (260.25–650.75) | 455.50 | 0.280 |
Endocrine | 4 (7.84) | 339.75 (160.00–584.75) | 241.00 | 0.080 |
Seizure(s) | 8 (15.69) | 137.13 (23.02–316.32) | 39.00 | 0.732 |
Motor weakness | 8 (15.69) | 62.38 (17.38–129.04) | 29.50 | 0.276 |
Head tilt | 5 (9.80) | 7.80 (3.81–11.50) | 8.00 | 0.021 |
Cranial nerve palsy | 2 (3.92) | 97.00 (65.00–139.00) | 97.00 | 0.942 |
Altered consciousness | 2 (3.92) | 7.00 (6.00–8.00) | 7.00 | 0.018 |
General symptoms | 12 (23.53) | 86.75 (18.80–175.55) | 14.50 | 0.703 |