Jasper K W Gerritsen1, Marike L D Broekman2, Steven De Vleeschouwer3, Philippe Schucht4, Christine Jungk5, Sandro M Krieg6, Brian V Nahed7, Mitchel S Berger8, Arnaud J P E Vincent9. 1. Department of Neurosurgery, Erasmus Medical Center, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands. j.gerritsen@erasmusmc.nl. 2. Department of Neurosurgery, Haaglanden Medical Center, The Hague, The Netherlands. 3. Department of Neurosurgery, University Hospital, Leuven, Belgium. 4. Department of Neurosurgery, University Hospital, Bern, Switzerland. 5. Department of Neurosurgery, University Hospital, Heidelberg, Germany. 6. Department of Neurosurgery, Technical University, Munich, Germany. 7. Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, USA. 8. Department of Neurosurgery, University of California, San Francisco, CA, USA. 9. Department of Neurosurgery, Erasmus Medical Center, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.
Abstract
PURPOSE: Due to the lack of consensus on the management of glioblastoma patients, there exists variability amongst surgeons and centers regarding treatment decisions. Though, objective data about the extent of this heterogeneity is still lacking. We aim to evaluate and analyze the similarities and differences in neurosurgical practice patterns. METHODS: The survey was distributed to members of the neurosurgical societies of the Netherlands (NVVN), Europe (EANS), the United Kingdom (SBNS) and the United States (CNS) between January and March 2021 with questions about the selection of surgical modality and decision making in glioblastoma patients. RESULTS: Survey respondents (224 neurosurgeons) were from 41 countries. Overall, the most notable differences observed were the presence and timing of a multidisciplinary tumor board; the importance and role of various perioperative factors in the decision-making process, and the preferred treatment in various glioblastoma cases and case variants. Tumor boards were more common at academic centers. The intended extent of resection for glioblastoma resections in eloquent areas was limited more often in European neurosurgeons. We found a strong relationship between the surgeon's theoretical survey answers and their actual approach in presented patient cases. In general, the factors which were found to be theoretically the most important in surgical decision making were confirmed to influence the respondents' decisions to the greatest extent in practice as well. DISCUSSION: This survey illustrates the theoretical and practical heterogeneity among surgeons and centers in their decision making and treatment selection for glioblastoma patients. These data invite further evaluations to identify key variables that can be optimized and may therefore benefit from consensus.
PURPOSE: Due to the lack of consensus on the management of glioblastoma patients, there exists variability amongst surgeons and centers regarding treatment decisions. Though, objective data about the extent of this heterogeneity is still lacking. We aim to evaluate and analyze the similarities and differences in neurosurgical practice patterns. METHODS: The survey was distributed to members of the neurosurgical societies of the Netherlands (NVVN), Europe (EANS), the United Kingdom (SBNS) and the United States (CNS) between January and March 2021 with questions about the selection of surgical modality and decision making in glioblastoma patients. RESULTS: Survey respondents (224 neurosurgeons) were from 41 countries. Overall, the most notable differences observed were the presence and timing of a multidisciplinary tumor board; the importance and role of various perioperative factors in the decision-making process, and the preferred treatment in various glioblastoma cases and case variants. Tumor boards were more common at academic centers. The intended extent of resection for glioblastoma resections in eloquent areas was limited more often in European neurosurgeons. We found a strong relationship between the surgeon's theoretical survey answers and their actual approach in presented patient cases. In general, the factors which were found to be theoretically the most important in surgical decision making were confirmed to influence the respondents' decisions to the greatest extent in practice as well. DISCUSSION: This survey illustrates the theoretical and practical heterogeneity among surgeons and centers in their decision making and treatment selection for glioblastoma patients. These data invite further evaluations to identify key variables that can be optimized and may therefore benefit from consensus.
Authors: Jasper K W Gerritsen; Marike L D Broekman; Steven De Vleeschouwer; Philippe Schucht; Brian V Nahed; Mitchel S Berger; Arnaud J P E Vincent Journal: Neurosurgery Date: 2021-01-13 Impact factor: 4.654
Authors: Matthew Mason; Normand Laperriere; Wolfgang Wick; David A Reardon; Annika Malmstrom; Elizabeth Hovey; Michael Weller; James R Perry Journal: Neurooncol Pract Date: 2015-09-01
Authors: Domenique M J Müller; Pierre A J T Robe; Roelant S Eijgelaar; Marnix G Witte; Martin Visser; Jan C de Munck; Marieke L D Broekman; Tatjana Seute; Jeroen Hendrikse; David P Noske; William P Vandertop; Frederik Barkhof; Mathilde C M Kouwenhoven; Emmanuel Mandonnet; Mitchel S Berger; Philip C De Witt Hamer Journal: JCO Clin Cancer Inform Date: 2019-01
Authors: Jasper Kees Wim Gerritsen; Marike Lianne Daphne Broekman; Steven De Vleeschouwer; Philippe Schucht; Brian Vala Nahed; Mitchel Stuart Berger; Arnaud Jean Pierre Edouard Vincent Journal: Neurooncol Pract Date: 2022-03-02