Patterns and Surgical Outcomes of Primary Brain Tumors Managed at a Tertiary Hospital in Arusha, Tanzania: a Cross-sectional Analysis

Purpose: The epidemiology of brain tumors varies globally between different countries and there is observed poor outcomes in lower- and middle-income countries. Our aim is to analyze the clinicopathological pattern of intracranial tumors in our setting and their post-surgical outcomes. Methods: This is a retrospective study. Data was obtained from clinical records of patients with intracranial tumors treated at our neurosurgery unit between 2019 and 2020. Only patients with primary brain tumors who underwent surgical intervention were included. Analysis was done to identify factors associated with patient outcomes (mortality/survival and performance status). Results: 39 patients with primary brain tumors underwent surgery (adults 72.8%, males 53.8%, mean age 35.8years). Gliomas (46.2%) comprised the most common tumor diagnosis overall and craniopharyngiomas were the most common tumors in pediatric patients (27.3%). Most patients (83.3%) had a poor performance status before surgery. Gross tumor resection (25.6%) was low and few patients (31.4%) underwent adjuvant therapy. 30-day mortality rate (10.3%) and one year mortality rate (46.2%) were high. Pediatric patients had a much worse outcome (46.2% mortality rate compared to 25% in adults, and 80% with poor performance status) as did males (38.1% mortality rate compared to 27.8% in females). Gliomas accounted for majority (69.2%) of the deaths. Conclusion: Delayed presentation and poor access to adjuvant therapies are important contributors of the high mortality and abandonment of treatment. Inadequate long-term follow-up is a hinderance to optimal neurooncological care in our setting.