Surgical outcomes and clinical profile of pediatric brain tumors: A 3-year retrospective analysis

Background: Pediatric brain tumors represent a major challenge in neuro-oncology, with significant morbidity and mortality in resource-limited settings. Data on surgical management and outcomes in Guinea remain extremely limited. This study aims to describe the clinical characteristics, surgical management, and short-term outcomes of pediatric brain tumor patients treated at the University Hospital of Conakry, Guinea. Methods: This retrospective descriptive study included all patients aged 0–18 years who underwent craniotomy for brain tumor resection at the CHU of Conakry from November 2022 to October 2024. Variables analyzed included demographics, clinical presentation, diagnostic and surgical delays, tumor characteristics, extent of resection, perioperative complications, and outcome at 2-month follow-up. Favorable outcome was defined as a modified Rankin Scale score of 3 or less. Results: Thirty-two patients were included (17 males, 15 females; median age 8 years). Headache and vomiting were the most common presenting symptoms (50%). The median diagnostic delay was 7 months, and surgical delay was 3 weeks. Posterior fossa tumors predominated (59%), with medulloblastoma being the most common histology (22%), followed by pilocytic astrocytoma (19%) and ependymoma (16%). Total resection was achieved in only 9 patients (28%). Postoperative complications occurred in 24 patients (75%). At 2-month follow-up, 8 patients (25%) had favorable outcomes, while 24 (75%) had unfavorable outcomes including 15 deaths. The World Health Organization performance score was an independent predictor of mortality ( P < 0.05). Conclusion: This study highlights significant challenges in managing pediatric brain tumors in Guinea, characterized by prolonged diagnostic delays, low rates of complete resection, and high morbidity and mortality. These findings underscore the urgent need for improved early detection systems, enhanced neurosurgical infrastructure, and access to adjuvant therapies.