Assessment of accessibility to the diagnosis and treatment of brain tumors in Argentina: Preliminary results

Rabadán, Alejandra T.; Hernández, D; Vázquez, Néstor; Torino, Rafael; Marcelo, Blanco V

doi:10.4103/sni.sni_497_16

Cited by 6 publications

(4 citation statements)

References 12 publications

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“…17 19 20 21 22 23 24 25 The series with the greatest epidemiological power reported diagnostic accuracy in 95 to 98% of cases, and a meta-analysis with 1,480 cases reported a positive diagnostic probability of 96.2%, with a morbidity of 7.8% and mortality of 0.9% of cases. 1 10 26 27 28 Its diagnostic efficacy has not been surpassed by modern imaging, which still does not provide enough information to establish prognosis and guide clinical therapeutic decision making. 14 15 28…”

Section: Discussionmentioning

confidence: 99%

A Case Series of Stereotactic Biopsy of Brainstem Lesions through the Transfrontal Approach

et al. 2022

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Background and Importance Brainstem lesions may be unresectable or unapproachable. Regardless, the histopathological diagnosis is fundamental to determine the most appropriate treatment. We present our experience with transfrontal stereotactic biopsy technique for brainstem lesions as a safe and effective surgical route even when contralateral transhemispheric approach is required for preservation of eloquent tissue. Clinical Presentation Twenty-five patients underwent surgery by transfrontal approach. Medical records were reviewed for establishing the number of patients who had postoperative histopathological diagnosis and postoperative complications. Twenty-four patients (18 adults and 7 children) had histopathological diagnosis. There were 18 astrocytomas documented, of which 12 were high grade and 6 low grade. The other diagnoses included viral encephalitis, post–renal transplant lymphoproliferative disorder, nonspecific chronic inflammation, Langerhans cell histiocytosis, and two metastases. No case was hindered by cerebrospinal fluid loss or ventricular entry. Complications included a case of mesencephalic hemorrhage with upper limb monoparesis and a case of a partially compromised third cranial nerve in another patient without associated bleeding. Conclusion Stereotactic biopsy of brainstem lesions by transfrontal ipsilateral or transfrontal transhemispheric contralateral approaches is a safe and effective surgical approach in achieving a histopathological diagnosis in both pediatric and adult populations.

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Section: Discussionmentioning

confidence: 99%

A Case Series of Stereotactic Biopsy of Brainstem Lesions through the Transfrontal Approach

et al. 2022

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“…Many South American nations, including Uruguay and Argentina, have recognised the importance of multidisciplinary care for patients with brain tumours, and have invested in and incorporated neuro-oncology multi-disciplinary teams (MDTs) comprising neurosurgeons, radiation oncologists, and medical oncologists into mainstream neurosurgical practice. 15 , 17 , 18 Also, the availability and access to advanced imaging techniques such as positron emission tomography-computed tomography (PET-CT) has also widely increased, aiding in accurate diagnosis and treatment planning. 18 In addition, there has been a massive increase in the number of dedicated neuro-oncology centres, and to some degree, increased investment into neurosurgical training, and a consequent increase in the number of neurosurgical staff.…”

Section: The Current Status Of Neurosurgical Oncology In South Americ...mentioning

confidence: 99%

“… 18 In addition, there has been a massive increase in the number of dedicated neuro-oncology centres, and to some degree, increased investment into neurosurgical training, and a consequent increase in the number of neurosurgical staff. 14 , 17 For instance, in Brazil, there has been a significant increase in the number of neurosurgery training programs, with more than 36 programs currently available across the country. 14 Similarly, these programs are being held in Venezuela, Colombia, Ecuador, and Peru, among others.…”

Section: The Current Status Of Neurosurgical Oncology In South Americ...mentioning

confidence: 99%

Awake craniotomies in South America: Advancements, challenges, and future prospects

Bharadwaj,

Awuah,

Adebusoye

et al. 2024

J Cent Nerv Syst Dis

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BACKGROUND: Awake craniotomy has emerged as an advanced surgical technique, characterized by keeping the patient awake during brain surgery. In South America, awake craniotomies have grained traction in neurosurgical practices across various medical centres and hospitals, with notable practitioners contributing to its growth and refinement in the region. PURPOSE: This study aims to explore the integration and impact of awake craniotomies in South American neurosurgical practices. The focus is on understanding the benefits, challenges, and potential transformative effects of the procedure in the region. RESEARCH DESIGN: A comprehensive narrative review and analysis through a thorough examination of the existing literature. RESULTS: The findings indicate that awake craniotomies in South America offer substantial benefits, including cost savings thorugh reduced hospitalization time, quicker recovery and decreased morbidity. Enhanced safety, effective pain management and reduced anaesthesia also contribute to this. CONCLUSION: Whilst the adaptation of awake craniotomies in South America holds great promise in transforming neurosurgical care in the region, significant challenges hinder its widespread adoption. Inadequate infrastructure, limited access to equipment, financial instability, and shortages in trained healthcare providers represent challenges that need to be addressed.

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“…The healthcare that patients in the Buenos Aires Metropolitan Area receive depends on their socioeconomic status and where they live [10]. To date there is only one published study that analyzed brain cancer patients' access to treatment and their outcomes in Argentina [11]. This previous work showed significant differences between public and private institutions throughout the country and the lack of access to specialized brain tumor teams.…”

Section: Introductionmentioning

confidence: 99%

Effects of time to chemoradiation on high-grade gliomas from the Buenos Aires Metropolitan Area

et al. 2021

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High-Grade Gliomas (HGG) are the most frequent brain tumor in adults. The gold standard of clinical care recommends beginning chemoradiation within 6 weeks of surgery. Disparities in access to healthcare in Argentina are notorious, often leading to treatment delays. We conducted this retrospective study to evaluate if time to chemoradiation after surgery is correlated with progression-free survival (PFS). Our study included clinical cases with a histological diagnosis of Glioblastoma (GBM), Anaplastic Astrocytoma (AA) or High-Grade Glioma (HGG) in patients over 18 years of age from 2014 to 2020. We collected data on clinical presentation, type of resection, time to surgery, time to chemoradiation, location within the Buenos Aires Metropolitan Area (BAMA) and type of health insurance. We found 63 patients that fit our inclusion criteria, including 26 (41.3%) females and 37 (58.7%) males. Their median age was 54 years old (19–86). Maximal safe resection was achieved in 49.2% (n = 31) of the patients, incomplete resection in 34.9% (n = 22) and the other 15.9% (n = 10) received a biopsy, but no resection. The type of health care insurance was almost evenly divided, with 55.6% (n = 35) of the patients having public vs. 44.4% (n = 28) having private health insurance. Median time to chemoradiation after surgery was 8 (CI 6.68–9.9) weeks for the global population. When we ordered the patients PFS by time to chemoradiation we found that there was a statistically significant effect of time to chemoradiation on patient PFS. Patients had a PFS of 10 months (p = 0.014) (CI 6.89–13.10) when they received chemoradiation <5 weeks vs a PFS of 7 months (CI 4.93–9.06) when they received chemoradiation between 5 to 8 weeks and a PFS of 4 months (CI 3.76–4.26 HR 2.18 p = 0.006) when they received chemoradiation >8 weeks after surgery. Also, our univariate and multivariate analysis found that temporal lobe location (p = 0.03), GMB histology (p = 0.02) and biopsy as surgical intervention (p = 0.02) all had a statistically significant effect on patient PFS. Thus, time to chemoradiation is an important factor in patient PFS. Our data show that although an increase in HGG severity contributes to a decrease in patient PFS, there is also a large effect of time to chemoradiation. Our results suggest that we can improve patient PFS by making access to healthcare in Buenos Aires more equitable by reducing the average time to chemoradiation following tumor resection.

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Assessment of accessibility to the diagnosis and treatment of brain tumors in Argentina: Preliminary results

Cited by 6 publications

References 12 publications

A Case Series of Stereotactic Biopsy of Brainstem Lesions through the Transfrontal Approach

A Case Series of Stereotactic Biopsy of Brainstem Lesions through the Transfrontal Approach

Awake craniotomies in South America: Advancements, challenges, and future prospects

Effects of time to chemoradiation on high-grade gliomas from the Buenos Aires Metropolitan Area

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