Reconfiguration from emergency to urgent elective neurosurgery for glioblastoma patients improves length of stay, surgical adjunct use, and extent of resective surgery.
Sun, Rosa Sharma, Shivam Benghiat, Helen Meade, Sara Sanghera, Paul Bramwell, Gregory Nagaraju, Santhosh Pohl, Ute Dawson, Camilla Petrik, Vladimir
Sun, Rosa
Sharma, Shivam
Benghiat, Helen
Meade, Sara
Sanghera, Paul
Bramwell, Gregory
Nagaraju, Santhosh
Pohl, Ute
Dawson, Camilla
Petrik, Vladimir
Abstract
Background: Glioblastoma (GB) is the most common intrinsic brain cancer and is notorious for its aggressive nature. Despite widespread research and optimization of clinical management, the improvement in overall survival has been limited. The aim of this study was to characterize the impact of service reconfiguration on GB outcomes in a single centre.
Methods: Patients with a histopathological confirmation of a diagnosis of GB between 01/01/2014 and 31/12/2019 were retrospectively identified. Demographic and tumour characteristics, survival, treatment (surgical and oncological), admission status, use of surgical adjunct (5-aminolevulinic acid, intra-operative neuro-monitoring), the length of stay, extent of resection, and surgical complications were recorded from the hospital databases.
Results: From August 2018 the neurosurgical oncology service was reconfigured to manage high-grade tumours on an urgent outpatient basis by surgeons specializing in oncology. We demonstrate that these changes resulted in an increase in elective admissions, greater use of intra-operative adjuncts resulting in the improved extent of tumour resection, and a reduction in median length of stay and associated cost-savings.
Conclusions: Optimizing neuro-oncology patient management through service reconfiguration resulted in increased use of intra-operative adjuncts, improved surgical outcomes, and reduced hospital costs. These changes also have the potential to improve survival and disease-free progression for patients with GB.
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Date
2022-05-02
Type
Article
Subject
Surgery, Radiology, Oncology. Pathology.
Collections
Citation
Sun R, Sharma S, Benghiat H, Meade S, Sanghera P, Bramwell G, Nagaraju S, Pohl U, Dawson C, Petrik V, Ughratdar I, White A, Zisakis A, Ramalingam S, Sawlani V, Watts C, Wykes V. Reconfiguration from emergency to urgent elective neurosurgery for glioblastoma patients improves length of stay, surgical adjunct use, and extent of resective surgery. Neurooncol Pract. 2022 May 2;9(5):420-428. doi: 10.1093/nop/npac03
Journal / Source Title
Neuro-Oncology Practice
DOI
10.1093/nop/npac034
PMID
36127892
Publisher
Oxford University Press
Publisher’s URL
https://academic.oup.com/nop