DISP-01. TEN YEARS OF PEDIATRIC LOW-GRADE GLIOMA CARE IN KENYA: UNVEILING GAPS AND PROGRESS TOWARD GLOBAL CHILDHOOD CANCER EQUITY

Abstract BACKGROUND Pediatric low-grade gliomas (pLGGs) are among the six index cancers prioritized by the WHO’s Global Initiative for Childhood Cancer due to their excellent prognosis with appropriate treatment. However, data from low- and middle-income countries like Kenya remain sparse. This study assessed clinical characteristics, care timelines, treatment outcomes, and survival among children with pLGGs treated at Kenya’s largest referral hospital, to assess progress and identify gaps toward achieving global childhood cancer equity. METHODS This retrospective cohort study included pediatric patients (≤18 years) who underwent surgery for histologically confirmed low-grade gliomas between January 2014 and December 2023. Data were extracted from clinical, imaging, and pathology records. Descriptive statistics, Kaplan-Meier analysis, and multivariable Cox regression were performed. RESULTS The cohort consisted of 84 patients (52 males; mean age of 8.8 ± 4.7 years). Headache (76.2%), vomiting (41.7%), seizures (28.6%), and limb weakness (27.4%) were the most common symptoms. Median time from symptom onset to imaging was 61 days, and to surgery was 97 days. Gross total resection was achieved in 58.3% of cases, and 76.2% had good immediate postoperative function (GOS 5). The most common histology was pilocytic astrocytoma (n=55, 65.5%). No molecular testing was performed. Only 6% received adjuvant therapy. At last follow-up, 41(48.8%) of patients were deceased, with most deaths (65.8%) occurring within one-year post-surgery. Median overall survival was 1,408 days, with 6- and 12-month survival rates of 74% and 68%, respectively. Male sex, limited tumor resection, and poor postoperative function predicted worse outcomes. CONCLUSION While surgical care provided favorable short-term functional outcomes, long-term survival for Kenyan children with pLGGs remains substantially lower than in high-income countries. These findings underscore critical gaps in early diagnosis, access to comprehensive oncology services, and long-term follow-up. These findings call for urgent development of robust pediatric neuro-oncology multidisciplinary care and structured long-term follow-up pathways.