COMPREHENSIVE ANALYSIS OF PEDIATRIC POSTERIOR FOSSA TUMORS: PATIENT CHARACTERISTICS, TREATMENT EXPERIENCE, AND SURVIVAL OUTCOMES

Abstract

Background: Pediatric posterior fossa ‘tumors (PFTs) are among the most common childhood brain tumors and a major cause of neurological morbidity and mortality. Their deep location often leads to rapid neurological deterioration and delayed diagnosis. Aim: To analyze patient characteristics, clinical presentation, treatment experience, and survival outcomes of pediatric posterior fossa tumors. Methodology: A retrospective observational cohort study was conducted on 77 patients (≤18 years) treated surgically between May 2019 and May 2025 at Department of Neurosurgery, Indira Gandhi Institute of Medical Sciences (I.G.I.M.S.), Patna, Bihar, India. Demographic data, symptoms, histopathology, extent of resection, adjuvant therapy, and survival were evaluated using descriptive statistics and survival analysis. Results: The most affected age group was 4–7 years (32.47%) with male predominance (58.44%). High-grade tumors constituted 59.74%. Intracranial hypertension (89.61%) and cerebellar deficits (81.82%) were the most common presentations. Pilocytic astrocytoma (29.87%) was the most frequent histology. Gross total resection was higher in low-grade tumors (77.42%) than high-grade tumors (56.52%). One-year survival was significantly better in low-grade tumors (96.77%) compared to high-grade tumors (73.91%). Conclusion: Tumor grade and extent of resection strongly influence outcomes. Early diagnosis and maximal safe resection with tailored adjuvant therapy’ improve survival in pediatric PFTs.