Histopathological Pattern and Outcome of Posterior Fossa Tumors in Children and Adults - A 20-Year Experience.

Abstract

Context:The postoperative quality and span of life in posterior fossa tumors (PFTs) is complicated by the residual disease, progression, recurrence, disabilities, and mortality.Aims:The aim of this study is to analyze the link between histopathological type of tumor and outcome in an ethnic Himalayan population of India.Settings and Design:The histopathological records of 410 out of 589 patients were compared with their clinical outcome up to the 1st postoperative year in a single center which amounts to regional epidemiological value of PFTs.Materials and Methods:In this observational study, retrospectively postoperative records of 589 PFTs from November 1990 to December 2010 (20 years) were retrieved, scrutinized, and observed. The postoperative records of 410 patients with proved histopathological examination results were included.Statistical Analysis Used:The statistical law of variance was applied wherever necessary.Results:About 63.2% of 410 operated PTFs were males while females predominated in meningiomas and pineoblastomas. About 31.7% of PFTs were children (below 18 years.). About 54.1% of the cases were histologically malignant. The residual tumors comprised 40.2%, and symptoms of disease progression occurred in 10.9%. The tumor recurrence occurred in 14.3% while 6.0% of the patients developed severe disability. The overall mortality was 11.4% up to the 1st postoperative year, with 18.9% in malignant patients. The first 1-year event-free survival (EFS) for all the patients was 66.0%. While the patients with malignancies had the first 1-year EFS of 47.7%, the histologically benign group had 87.7%.Conclusion:The first 1-year postoperative EFS of histologically benign and some malignant PFTs both in children and adults such as pilocytic astrocytomas, ependymomas, and pineoblastomas was much better (87.7%) than other malignant PTFs.