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Malignant peripheral nerve sheath tumors (MPNST) represent the leading cause of premature death in this population. This study analyzed 16-year temporal trends and regional disparities in pediatric NF\/MPNST mortality and hospitalizations in Brazil.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a nationwide ecological study of individuals aged 0\u201319\u00a0years from 2008 to 2023. Mortality data were obtained from the Mortality Information System (SIM) and hospital admissions from the Hospital Information System (SIH\/SUS), with temporal trends assessed using Prais\u2013Winsten regression. We calculated Age-Specific Mortality Rates (ASMRs) and assessed excess mortality risk using Standardized Mortality Ratios (SMR) to identify regional disparities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 177 pediatric deaths were identified, with MPNST accounting for 64.9% (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009115) and NF for 35.1% (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200962). SMR analysis revealed significant geographic inequalities. Children aged 0\u20139 in the South region faced a mortality risk double that of the reference population (SMR\u2009=\u20092.02; 95% CI 1.08\u20133.46;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.010), whereas adolescents in the North region exhibited significantly lower-than-expected mortality. Despite global therapeutic advances, mortality rates in Brazil remained statistically stagnant across all age groups and conditions (\n                      <jats:italic>p<\/jats:italic>\n                      values were non-significant). Conversely, NF-related hospitalizations demonstrated an increasing trend (+\u20092.98% annually for ages 0\u20139;\u2009+\u20091.94% for ages 10\u201319), while MPNST admissions remained stable.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Pediatric mortality from NF and MPNST in Brazil has remained unchanged for 16\u00a0years, contrasting with the rising trend in NF-related hospitalizations. This discrepancy, coupled with marked regional disparities, suggests persistent structural challenges in early diagnosis and equitable access to specialized oncology care. These findings highlight a critical need for national notification systems and improved therapeutic strategies for affected children and adolescents.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00381-026-07415-5","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T07:09:58Z","timestamp":1784876998000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pediatric mortality from neurofibromatosis and malignant peripheral nerve sheath tumors in Brazil, 2008\u20132023: a 16-year nationwide analysis of persistent disparities"],"prefix":"10.1007","volume":"42","author":[{"given":"Karina Munhoz de Paula Alves","family":"Coelho","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Guilherme","family":"Pickler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 C\u00e2ndido Caldeira","family":"Xavier-J\u00fanior","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis Rossetti","family":"Pedack","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raquel Francine Liermann","family":"Garcia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos Frederico","family":"Fronza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruna Louise","family":"Silva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Acir Alves Coelho","family":"Junior","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo Henrique Condeixa","family":"de Fran\u00e7a","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00e1rbara Sarni","family":"Sanches","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priscila Ferraz","family":"Franczak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gustavo Rassier","family":"Isolan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo Gerardin Poirot","family":"Land","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6016-2261","authenticated-orcid":false,"given":"Rafael","family":"Roesler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,24]]},"reference":[{"key":"7415_CR1","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2017.4","volume":"3","author":"DH Gutmann","year":"2017","unstructured":"Gutmann DH, Ferner RE, Listernick RH, Korf BR, Wolters PL, Johnson KJ (2017) Neurofibromatosis type 1. 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