Initial symptoms and diagnostic delay in children with brain tumors at a single institution in Japan.
brain tumor
children
diagnostic delay
initial symptom
visual, hearing, and smelling abnormalities
Journal
Neuro-oncology practice
ISSN: 2054-2577
Titre abrégé: Neurooncol Pract
Pays: England
ID NLM: 101640528
Informations de publication
Date de publication:
Feb 2021
Feb 2021
Historique:
entrez:
5
3
2021
pubmed:
6
3
2021
medline:
6
3
2021
Statut:
epublish
Résumé
A prolonged interval between onset of symptoms and diagnosis of childhood brain tumor is associated with worse neurological outcomes. The objectives of this study are to determine factors contributing to diagnostic delay and to find an interventional focus for further reduction in the interval between symptom onset and diagnosis in Japan. We retrospectively analyzed 154 patients younger than 18 years with newly diagnosed brain tumors who visited our institution from January 2002 to March 2013. The median age at diagnosis was 6.2 years and the median total diagnostic interval (TDI) was 30 days. Patients with low-grade tumors and cerebral midline tumor location had significantly long TDI. Durations between the first medical consultation and diagnosis (diagnostic interval, DI) were exceedingly longer for patients with visual, hearing, or smelling abnormalities as the first symptom (median, 303 days). TDI and DI of patients who visited ophthalmologists or otolaryngologist for the first medical consultation were significantly longer. Among these patients, longer DI was associated with worse visual outcome. Raising awareness of brain tumor diagnosis among ophthalmologists and otolaryngologists may reduce diagnostic delay and may improve the neurological impairment of children with brain tumors in Japan.
Sections du résumé
BACKGROUND
BACKGROUND
A prolonged interval between onset of symptoms and diagnosis of childhood brain tumor is associated with worse neurological outcomes. The objectives of this study are to determine factors contributing to diagnostic delay and to find an interventional focus for further reduction in the interval between symptom onset and diagnosis in Japan.
METHODS
METHODS
We retrospectively analyzed 154 patients younger than 18 years with newly diagnosed brain tumors who visited our institution from January 2002 to March 2013.
RESULTS
RESULTS
The median age at diagnosis was 6.2 years and the median total diagnostic interval (TDI) was 30 days. Patients with low-grade tumors and cerebral midline tumor location had significantly long TDI. Durations between the first medical consultation and diagnosis (diagnostic interval, DI) were exceedingly longer for patients with visual, hearing, or smelling abnormalities as the first symptom (median, 303 days). TDI and DI of patients who visited ophthalmologists or otolaryngologist for the first medical consultation were significantly longer. Among these patients, longer DI was associated with worse visual outcome.
CONCLUSION
CONCLUSIONS
Raising awareness of brain tumor diagnosis among ophthalmologists and otolaryngologists may reduce diagnostic delay and may improve the neurological impairment of children with brain tumors in Japan.
Identifiants
pubmed: 33664970
doi: 10.1093/nop/npaa062
pii: npaa062
pmc: PMC7906264
doi:
Types de publication
Journal Article
Langues
eng
Pagination
60-67Informations de copyright
© The Author(s) 2020. Published by Oxford University Press on behalf of the Society for Neuro-Oncology and the European Association of Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Références
Arch Dis Child. 2010 Jul;95(7):534-9
pubmed: 20371594
J Neurooncol. 2019 Jun;143(2):297-304
pubmed: 30929127
Neuro Oncol. 2016 Mar;18(3):445-54
pubmed: 26523066
Jpn J Clin Oncol. 2017 Aug 1;47(8):762-771
pubmed: 28541571
Cancer Sci. 2018 Feb;109(2):422-434
pubmed: 29178401
Curr Probl Pediatr Adolesc Health Care. 2016 Jul;46(7):242-250
pubmed: 27230809
Eur J Cancer. 2009 Sep;45(14):2552-61
pubmed: 19616428
Br J Cancer. 2012 Mar 27;106(7):1262-7
pubmed: 22415239
Eur J Pediatr. 2002 Dec;161(12):663-7
pubmed: 12447667
Pediatr Int. 2014 Dec;56(6):829-833
pubmed: 24773698
Arch Dis Child. 2020 Apr;105(4):355-362
pubmed: 31653616
J Child Neurol. 2008 Feb;23(2):178-83
pubmed: 18160552
Lancet Oncol. 2007 Aug;8(8):685-95
pubmed: 17644483
J Clin Oncol. 2003 Sep 1;21(17):3255-61
pubmed: 12947060
Eur J Pediatr. 2009 Mar;168(3):303-10
pubmed: 18536935
Arch Dis Child. 2006 Jun;91(6):502-6
pubmed: 16547083
Bone Marrow Transplant. 2013 Mar;48(3):452-8
pubmed: 23208313
Pediatr Blood Cancer. 2018 Aug;65(8):e27063
pubmed: 29741274
Childs Nerv Syst. 2015 Jul;31(7):1067-77
pubmed: 25742877