Expertise in surgical neuro-oncology. Results of a survey by the EANS neuro-oncology section.

Gousias, K; Hoyer, A; Mazurczyk, L A; Bartek, J; Bruneau, M; Celtikci, E; Foroglou, N; Freyschlag, C; Grossman, R; Jungk, C; Metellus, P; Netuka, D; Rola, R; Schucht, Philippe; Senft, C; Signorelli, F; Vincent, A J P E; Simon, M (2024). Expertise in surgical neuro-oncology. Results of a survey by the EANS neuro-oncology section. Brain and Spine, 4(102822) Elsevier 10.1016/j.bas.2024.102822

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INTRODUCTION

Technical advances and the increasing role of interdisciplinary decision-making may warrant formal definitions of expertise in surgical neuro-oncology.

RESEARCH QUESTION

The EANS Neuro-oncology Section felt that a survey detailing the European neurosurgical perspective on the concept of expertise in surgical neuro-oncology might be helpful.

MATERIAL AND METHODS

The EANS Neuro-oncology Section panel developed an online survey asking questions regarding criteria for expertise in neuro-oncological surgery and sent it to all individual EANS members.

RESULTS

Our questionnaire was completed by 251 respondents (consultants: 80.1%) from 42 countries. 67.7% would accept a lifetime caseload of >200 cases and 86.7% an annual caseload of >50 as evidence of neuro-oncological surgical expertise. A majority felt that surgeons who do not treat children (56.2%), do not have experience with spinal fusion (78.1%) or peripheral nerve tumors (71.7%) may still be considered experts. Majorities believed that expertise requires the use of skull-base approaches (85.8%), intraoperative monitoring (83.4%), awake craniotomies (77.3%), and neuro-endoscopy (75.5%) as well as continuing education of at least 1/year (100.0%), a research background (80.0%) and teaching activities (78.7%), and formal interdisciplinary collaborations (e.g., tumor board: 93.0%). Academic vs. non-academic affiliation, career position, years of neurosurgical experience, country of practice, and primary clinical interest had a minor influence on the respondents' opinions.

DISCUSSION AND CONCLUSION

Opinions among neurosurgeons regarding the characteristics and features of expertise in neuro-oncology vary surprisingly little. Large majorities favoring certain thresholds and qualitative criteria suggest a consensus definition might be possible.

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