- Pediatric neuro-oncological diseases pose significant challenges due to their diverse mortality and morbidity rates. This study aims to assess in-hospital mortality and morbidity associated with these conditions in neurosurgical departments across Germany in 2023, focusing on pediatric patients undergoing neurosurgical procedures.
Methods
A cross-sectional study was conducted on pediatric neuro-oncological cases treated in German neurosurgical departments in 2023. The analysis targeted patients under 18 diagnosed with malignant brain tumors (ICD-10-GM code C71). Collected data included demographics, primary and secondary diagnoses, and neurosurgical procedures performed. In-hospital mortality was defined as a fatal outcome before discharge.
Results
In 2023, a total of 5,585 pediatric cases of malignant gliomas were reported in German neurosurgical departments, with 42.7% of patients being female. The highest incidence (28.4%; 1,586/5,585) was observed in children aged 6 to 9 years.Pediatric neuro-oncological diseases pose significant challenges due to their diverse mortality and morbidity rates. This study aims to assess in-hospital mortality and morbidity associated with these conditions in neurosurgical departments across Germany in 2023, focusing on pediatric patients undergoing neurosurgical procedures.
Methods
A cross-sectional study was conducted on pediatric neuro-oncological cases treated in German neurosurgical departments in 2023. The analysis targeted patients under 18 diagnosed with malignant brain tumors (ICD-10-GM code C71). Collected data included demographics, primary and secondary diagnoses, and neurosurgical procedures performed. In-hospital mortality was defined as a fatal outcome before discharge.
Results
In 2023, a total of 5,585 pediatric cases of malignant gliomas were reported in German neurosurgical departments, with 42.7% of patients being female. The highest incidence (28.4%; 1,586/5,585) was observed in children aged 6 to 9 years. The overall in-hospital mortality rate was 0.7%, with 39 patients succumbing to the disease. Among these cases, 1,981 involved cerebellar tumors. A significant male predominance was found in cerebellar tumor cases (62.8% vs. 37.2%, p < .0001, Chi-square test). Interestingly, 33.3% of cerebellar tumors were diagnosed in children aged 10 to 15 years. Commonly performed neurosurgical procedures included the excision and destruction of primary brain tumor tissue (5-015.0; 312/1,063 of the recorded procedures), biopsies (open and stereotactic combined; 1-510 and 1-511; 90/1,063), and reoperations (5-983; 111/1,063). Advanced intraoperative techniques were employed at varying rates: microsurgery in 77.9% (5-984), intraoperative navigation systems in 58.9% (5-988.0, 5-988.2, 5-988.3), fluorescence guidance in 6% (5-989), and intraoperative neuro-monitoring (IONM) in 36.5% (8-925). The mortality rate for primary tumor resections was recorded at 1.92% (6/312). No fatalities were reported for biopsy or reoperation procedures.
Conclusions
This ongoing study provides crucial insights into the epidemiology and in-hospital outcomes of pediatric neuro-oncological cases in Germany. A notable predominance of cerebellar tumors in males was observed. While most pediatric brain tumors are diagnosed between the ages of 6 and 9 years, cerebellar tumors were more frequently identified in children aged 10 to 15 years. The most commonly performed surgical procedures were tumor resections, biopsies, and reoperations. The mortality rate for tumor resections reached up to 1.92%. However, advanced intraoperative techniques, including microsurgical approaches, intraoperative navigation systems, IONM, and fluorescence-guided surgery, were less frequently utilized in pediatric patients compared to adults.…
