Recurrent brain tumors at the largest referral facility in East and Central Africa- epidemiology, patterns and outcomes: a descriptive study

Abstract

Introduction: The prognosis of brain tumors once treated is variable with outcomes ranging from complete resolution of symptoms to recurrence of the tumor. Different geographical regions worldwide have different recurrence patterns. This paper describes the epidemiology, patterns and outcomes of recurrence in Sub-Saharan Africa. Methods: A three-year retrospective study starting January 2014 to December 2016 was carried out at the records department of Kenyatta National Hospital (KNH) following ethical approval. A pre-formed questionnaire was filled in with data from files that fit in the inclusion criteria. Data was analyzed using Statistical Package for Social Sciences (SPSS) Version 20. Results: A total of 18 files were retrieved and reviewed. There were 11 male and 7 female patients with the tumors most commonly occurring in the 0-13 and 26-45 years’ age groups. Supratentorial tumors accounted for 66.7% and the commonest among these were craniopharyngiomas at 50.0%. The more common recurring infratentorial brain tumors were medulloblastoma and hemangioblastoma. Surgical interventions were carried out in all patients and the recurrence periods ranged from less than 6 months to greater than 5 years. Fifty-five (55%) percent of the recurrent tumors had a Zubrod score of 0-1. Conclusion: Craniopharyngiomas were the most common recurrent brain tumors seen in this resource limited setting as shown in this study. Despite the resource scarcity, more than half of our patients had a good outcome. Closer follow up with stringent surveillance and provision of adjuvant chemo and radiation therapy with surgery for treatment of recurrences would lead to better outcomes.