Background: Pediatric brain tumors (PBT) are among the most common childhood neoplasms worldwide, but their management in low- and middle-income countries (LMICs) remains under-documented. Limited access to specialized care, diagnostic tools, and adjuvant therapies poses significant challenges in sub-Saharan Africa, including Togo. Objective: This study reviews the management of pediatric brain tumors in Togo. Methods: We conducted a retrospective study in the neurosurgery department at Sylvanus Olympio Teaching Hospital between November 2017 and December 2022. Demographic, clinical, radiographic, operative, pathology, and outcome data were collected and analyzed. Results: Eighteen patients had histologically verified brain tumors. Ages ranged from 1 to 15 years (mean: 7.73 ± 4.28), with a sex ratio of 1. Symptoms of raised intracranial pressure were present in 83.4% of cases. The mean interval to presentation was 22 ± 5.32 months. Tumors were supratentorial in 66.7% of cases. Total tumor removal was achieved in 61.1%. Astrocytoma was the most common histological diagnosis, followed by ependymoma and medulloblastoma. Five patients (27.8%) died within the first month post-surgery. The estimated 5-year survival rate was 43% ± 5.4%. Conclusion: Delayed diagnosis, insufficient infrastructure, and limited access to radiotherapy and chemotherapy contribute to poor outcomes. Improving neurosurgical capacity, infrastructure, and financial support could enhance survival and outcomes for pediatric brain tumor patients in Togo.
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