Objectives Resection rates for paediatric brain tumours correlate with outcome. At the 2018 BPNG meeting a commitment to prospectively collect resection data was made. Here we review our posterior fossa resection rates for the last decade.

Design Retrospective observational cohort study of paediatric posterior fossa astrocytomas, medulloblastomas and ependymomas from 2008–2018. Primary outcome measure was extent of resection on post-op MRI, with secondary outcomes including post-op complications and need for temporary/permanent CSF diversion.

Subjects 57 patients had 62 operations for: 26 astrocytomas, 28 medulloblastomas and 8 ependymomas. Ages ranged from 7 months-16 years, with a median of 9, 7 and 6 years, respectively, and an even male: female split. Follow-up ranged from 2 months to >10 years.

Methods Patients were identified from a prospectively collected paediatric neuro-oncology database, with clinical notes and peri-operative imaging used for analysis. Our results were compared to the published literature.

Results Complete resection (CR) rates after 1 st surgery for patients with astrocytomas, medulloblastomas and ependymomas were 77%, 79% and 63%, respectively. 5/57 patients had a 2nd operation later, 3 of whom had primary CR followed by recurrence.

Conclusions Our resection rates, complications and need for CSF diversion are comparable to the literature. Factors enabling this in a low-volume centre may include a robust paediatric neuro-oncology framework, fellowship-trained subspecialty surgeons and joint operating.