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Peer-reviewedCC BYFrontiers in pediatrics

Diagnostic delay as a prognostic factor for non-response to treatment and relapse in Mexican pediatric patients with central nervous system tumors

  • Juan-Carlos Pérez-De Marcos1
  • Manuel Castillejos-López2
  • Arnoldo Aquino-Gálvez3
  • Liliana Velasco-Hidalgo4
  • Rocío Cárdenas-Cardos4
  • Ana María Niembro-Zúñiga4
  • Armando De Uña-Flores5
  • Marta Zapata-Tarrés6
  • Luz-María Torres-Espíndola1
6 affiliations
  1. 1Laboratorio de Farmacología, Instituto Nacional de Pediatría , ,
  2. 2Laboratorio de Investigación en Epidemiología e Infectología, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas , ,
  3. 3Laboratorio de Biología Molecular, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas” , ,
  4. 4Servicio de Oncología, Instituto Nacional de Pediatría , ,
  5. 5Servicio de Radiología e Imagen, Instituto Nacional de Pediatría , ,
  6. 6Titular de la Comisión Coordinadora de Institutos Nacionales de Salud y Hospitales de Alta Especialidad , ,
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Abstract

Background: Central nervous system tumors (CNST) are among the most common solid tumors in children and represent a major cause of cancer-related morbidity and mortality. Early diagnosis is essential to improve treatment outcomes; however, nonspecific symptoms often lead to diagnostic delays. Prolonged time to diagnosis may allow disease progression and negatively affect treatment response. Understanding the impact of diagnostic delays can help identify barriers to timely care and improve clinical outcomes in pediatric patients.

Objective: This study aimed to explore the link between diagnostic delays and relapse on treatment non-response in pediatric patients with central nervous system tumors (CNST).

Methods: A cohort of 111 patients with newly diagnosed CNST tumors was evaluated. Treatment response was assessed using Response Assessment in Neuro-Oncology (RANO) criteria. A diagnostic delay was considered when the diagnosis was made more than 1, 3, or 6 months after the initial clinical presentation. Kaplan–Meier curves were plotted to assess the probability of treatment response by diagnostic delay of more than 1, 3, and 6 months.

Results: The median time from symptom onset to diagnosis was 80 days (Q2529–Q75195). Kaplan–Meier analysis showed that diagnostic delays >1 and >3 months were associated with a higher probability of non-response to treatment (p = 0.014 and p = 0.004, respectively). In multivariable Cox analysis adjusted for age and sex, delays >1 month (HR 2.003, 95% CI 1.23–3.24; p = 0.005) and >3 months (HR 1.86, 95% CI 1.20–2.88; p = 0.005) were associated with non-response. Diagnostic delays >1 month (HR 2.690, 95% CI 1.19–6.34; p = 0.043) and >3 months (HR 2.083, 95% CI 1.08–3.96; p = 0.048) were also associated with relapse.

Conclusion: A delay in diagnosis of more than 1 and 3 months was significantly associated with lack of response to treatment and relapse in patients diagnosed with CNST.

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Cite

BibTeXRIS
BibTeX
@article{marcos2026diagnostic,
  title = {{Diagnostic delay as a prognostic factor for non-response to treatment and relapse in Mexican pediatric patients with central nervous system tumors}},
  author = {Juan-Carlos Pérez-De Marcos and Manuel Castillejos-López and Arnoldo Aquino-Gálvez and Liliana Velasco-Hidalgo and Rocío Cárdenas-Cardos and Ana María Niembro-Zúñiga and Armando De Uña-Flores and Marta Zapata-Tarrés and Luz-María Torres-Espíndola},
  journal = {Frontiers in pediatrics},
  year = {2026},
  month = oct,
  doi = {10.3389/fped.2026.1900510},
  url = {https://europepmc.org/article/PMC/PMC13727642},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Diagnostic delay as a prognostic factor for non-response to treatment and relapse in Mexican pediatric patients with central nervous system tumors
AU  - Juan-Carlos Pérez-De Marcos
AU  - Manuel Castillejos-López
AU  - Arnoldo Aquino-Gálvez
AU  - Liliana Velasco-Hidalgo
AU  - Rocío Cárdenas-Cardos
AU  - Ana María Niembro-Zúñiga
AU  - Armando De Uña-Flores
AU  - Marta Zapata-Tarrés
AU  - Luz-María Torres-Espíndola
PY  - 2026
DA  - 2026/10/20
JO  - Frontiers in pediatrics
DO  - 10.3389/fped.2026.1900510
UR  - https://europepmc.org/article/PMC/PMC13727642
AB  - Background: Central nervous system tumors (CNST) are among the most common solid tumors in children and represent a major cause of cancer-related morbidity and mortality. Early diagnosis is essential to improve treatment outcomes; however, nonspecific symptoms often lead to diagnostic delays. Prolonged time to diagnosis may allow disease progression and negatively affect treatment response. Understanding the impact of diagnostic delays can help identify barriers to timely care and improve clinical outcomes in pediatric patients.  Objective: This study aimed to explore the link between diagnostic delays and relapse on treatment non-response in pediatric patients with central nervous system tumors (CNST).  Methods: A cohort of 111 patients with newly diagnosed CNST tumors was evaluated. Treatment response was assessed using Response Assessment in Neuro-Oncology (RANO) criteria. A diagnostic delay was considered when the diagnosis was made more than 1, 3, or 6 months after the initial clinical presentation. Kaplan–Meier curves were plotted to assess the probability of treatment response by diagnostic delay of more than 1, 3, and 6 months.  Results: The median time from symptom onset to diagnosis was 80 days (Q2529–Q75195). Kaplan–Meier analysis showed that diagnostic delays >1 and >3 months were associated with a higher probability of non-response to treatment (p = 0.014 and p = 0.004, respectively). In multivariable Cox analysis adjusted for age and sex, delays >1 month (HR 2.003, 95% CI 1.23–3.24; p = 0.005) and >3 months (HR 1.86, 95% CI 1.20–2.88; p = 0.005) were associated with non-response. Diagnostic delays >1 month (HR 2.690, 95% CI 1.19–6.34; p = 0.043) and >3 months (HR 2.083, 95% CI 1.08–3.96; p = 0.048) were also associated with relapse.  Conclusion: A delay in diagnosis of more than 1 and 3 months was significantly associated with lack of response to treatment and relapse in patients diagnosed with CNST.
SN  - 2296-2360
ER  -