Brain Tumours in Rural North East Malaysia

Reliable data on the epidemiology of brain tumours is essential for planning health services and research. The objectives of this study are to determine the epidemiologic distribution and the incidence of brain tumours less than 4 cm in diameter and to identify factors associated with poor outcome. All cases of brain tumour admitted to Hospital University Sains Malaysia between 1st January 1990 and 31st December 1996 were included. Computerized Tomographic (CT) scan of the brain was done on all patients. The tumours were diagnosed based on their appearance on CT scan, and clinical course with or without tissue diagnosis. The size of the brain tumour was measured manually from the axial CT scan films using the ABC/2 technique. The classification of brain tumours was based on the recent World Health Organization classification. The incidence of brain tumours in this region was low (0.4 per 100.000 population), with no significant gender preponderance. Neuroglial tumours (35%) were the most common brain tumours followed by meningiomas (33%), medulloblastomas (12%) and schwannomas (6%). The incidence of brain tumour with a size less than 4 cm in diameter and less than 30 cc in volume was 68.2% and 58.7% respectively. The incidence of brain tumours located in eloquent areas was 21.7%. One-year survival rate in this study was better with combination of treatment modalities (surgery and radiotherapy), and Karnofsky performance scale was identified as the only important prognostic factor for the survival outcome. In conclusion, the incidence of brain tumours in this region (Kelantan and Terengganu) is low and the size of brain tumours less than 4 cm is common.