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Decision making and surgical modality selection in glioblastoma patients: an international multicenter survey

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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.

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Data availability

The datasets generated during and analysed during the current study are not publicly available due to ethical reasons, but are available from the corresponding author on reasonable request.

Code availability

R code is available from the corresponding author on reasonable request.

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Acknowledgements

We gratefully thank our colleagues for their time and effort in completing the survey.

Funding

None.

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Erasmus Medical Center, Doctor Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands

    Jasper K. W. Gerritsen & Arnaud J. P. E. Vincent

  2. Department of Neurosurgery, Haaglanden Medical Center, The Hague, The Netherlands

    Marike L. D. Broekman

  3. Department of Neurosurgery, University Hospital, Leuven, Belgium

    Steven De Vleeschouwer

  4. Department of Neurosurgery, University Hospital, Bern, Switzerland

    Philippe Schucht

  5. Department of Neurosurgery, University Hospital, Heidelberg, Germany

    Christine Jungk

  6. Department of Neurosurgery, Technical University, Munich, Germany

    Sandro M. Krieg

  7. Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, USA

    Brian V. Nahed

  8. Department of Neurosurgery, University of California, San Francisco, CA, USA

    Mitchel S. Berger

Authors
  1. Jasper K. W. Gerritsen
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  2. Marike L. D. Broekman
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  3. Steven De Vleeschouwer
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  4. Philippe Schucht
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  5. Christine Jungk
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  6. Sandro M. Krieg
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  7. Brian V. Nahed
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  8. Mitchel S. Berger
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  9. Arnaud J. P. E. Vincent
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Contributions

JKWG: study concept, study design, data acquisition, quality control of data and algorithms, data analysis and interpretation, manuscript drafting and manuscript editing. MLDB, SDV, PS: study concept, study design, data analysis and interpretation, manuscript drafting, manuscript editing and manuscript reviewing. CJ, SMK, BVN: this author helped with manuscript editing and manuscript reviewing. MSB, AJPEV: study concept, study design, data analysis and interpretation, manuscript drafting, manuscript editing and manuscript reviewing.

Corresponding author

Correspondence to Jasper K. W. Gerritsen.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Gerritsen, J.K.W., Broekman, M.L.D., De Vleeschouwer, S. et al. Decision making and surgical modality selection in glioblastoma patients: an international multicenter survey. J Neurooncol 156, 465–482 (2022). https://doi.org/10.1007/s11060-021-03894-5

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  • DOI: https://doi.org/10.1007/s11060-021-03894-5

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