Expertise in surgical neuro-oncology. Results of a survey by the EANS neuro-oncology section
Gousias K., Hoyer A., Mazurczyk LA., Bartek J., Bruneau M., Celtikci E., Foroglou N., Freyschlag C., Grossman R., Jungk C., Metellus P., Netuka D., Rola R., Schucht P., Senft C., Signorelli F., Vincent AJPE., Simon M., Agrawal R., Albano L., Alexiou GA., Ali A., Al-Mahfoudh R., Amoo M., Anagnostopoulos C., Bamps S., Bandyopadhyay S., Barone DG., Barone F., Barrit S., Behling F., Blaga A., Boukas A., Brennan P., Butenschoen VM., Campello M., Cara A., Chibbaro S., Chrenko R., Cifre Serra PJ., Clusmann H., Corell A., Cornelius JF., D'Andrea M., Demetriades AK., De Vleeschouwer S., Drexler R., Duerinck J., Fanarjyan RV., Fernandez-Coello A., Fountas K., Freiman TM., Gadzhiagaev V., Georgiopoulos M., Gilis N., Golubovic J., Lippi Fernandes EG., Grasso G., Guerrini F., Gulsuna B., Hill CS., Höhne J., Holling M., Iarmoliuk I., Ioan-Alexandru F., Ius T., Jacikevicius K., Jakola AS., Jakubowski P., Kalantzis G., Karabatsou K., Kirollos R., König R., Kozyrev DA., Krex D., Ladisich B., Lau R., Lizunou Y., Lombard A., Low HL., Alves JL., Maghrabi Y., Mammi M., Marji A., Massimi L., Mavridis I., McLean AL., Lawson McLean AC., Meyer B., Mohme M., Branco PM., Müther M., Musleh I., Nasiri D., Navarro R., Omerhodzic I., Oppong MD., Paidakakos NA., Pantera Z., Patel MA.
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.