Quality indicators in neuro-oncology: Review of the literature and development of a new quality indicator set for glioma care through a two-round Delphi survey

Vanhauwaert, Dimitri; Pinson, Harry; Sweldens, Caroline; Four, Stephanie Du; Eycken, Liesbet Van; Weyns, F.; Lefranc, Florence; Vanopdenbosch, Ludo; Michotte, Alex; Liefhooghe, Nick; Lammens, Martin; Clement, Paul W.; Whenham, Nicolas; Nyens, Bart; Tieleman, Ann; Goldman, Serge; Goethals, Ingeborg; Schutter, Harlinde De; Vleeschouwer, Steven De; Boterberg, Tom

doi:10.1007/s11060-022-03971-3

Cited by 3 publications

(5 citation statements)

References 30 publications

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“…While quality of care ultimately aims at excellent patient outcomes, quality of care highly depends on process quality. Besides defining quality indicators for quality of care assessments ( 5 ), detecting and reporting on adverse events and complications are therefore essential for continuously improving processes, and thus, improving the quality of care. Vecchio et al addressed the issue of adverse events following surgery in lower-grade gliomas, using the Landriel–Ibanez classification (LIC) and the Therapy-Disability-Neurology (TDN) score, reporting on postoperative complications in 47.6% of their patients.…”

Section: Quality Indicators and Adverse Eventsmentioning

confidence: 99%

Editorial: Quality of care of glioma patients

et al. 2022

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Section: Quality Indicators and Adverse Eventsmentioning

confidence: 99%

Editorial: Quality of care of glioma patients

et al. 2022

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“…The combination of genotypic and phenotypic parameters facilitates more accurate diagnosis and moreover, certain markers have both a prognostic and predictive value [6,[18][19][20]. Molecular testing in accordance with the WHO classification is also incorporated in QIs for the assessment of quality of glioma care [8][9][10]. Because of the incomplete overlap between the WHO and the ICD-O-3 classifications and the lagging of the latter, molecular information is most often missing in population-based cancer registration programmes.…”

Section: Discussionmentioning

confidence: 99%

“…This is, however, very relevant since molecular markers in brain tumours have diagnostic, prognostic, and predictive value [6,7]. Moreover, pathology reporting according to the most recent WHO classification and testing for the relevant molecular markers are established quality indicators (QIs) for assessment of the quality of glioma care [8][9][10]. For diffuse astrocytic tumours, the IDH status is acquired through IDH1-R132H immunohistochemistry (IHC) and/or next generation sequencing (NGS) in patients older than 55 years.…”

Section: Introductionmentioning

confidence: 99%

Cancer Registration, Molecular Marker Status, and Adherence to the WHO 2016 Classification of Pathology Reports for Glioma Diagnosed during 2017–2019 in Belgium

Vanhauwaert¹,

Pinson²,

Vanschoenbeek³

et al. 2023

Pathobiology

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Introduction: The objective of this study is to cross-check and if necessary, adjust registered ICD-O-3 topography and morphology codes with the findings in pathology reports available at the Belgian Cancer Registry (BCR) for glioma patients. Additionally, integration of molecular markers in the pathological diagnosis and concordance with WHO 2016 classification is investigated. Methods: Since information regarding molecular tests and corresponding conclusions are not available as structured data at population level, a manual screening of all pseudonymized pathology reports available at the BCR for registered glioma patients (2017-2019) was conducted. ICD-O-3 morphology and topography codes from the BCR database (based on information as provided by hospital oncological care programs and pathology labs), were, at tumour level, cross-checked with the data from the pathology reports and, if needed, specified or corrected. Relevant molecular markers (IDH-1/2, 1p19q codeletion, MGMTp) were manually extracted from the pathology reports. Results: In 95,3% of gliomas, the ICD-O-3 morphology code was correct. Non-specific topography codes were specified in 9,3%, while 3,3% of specific codes were corrected. The IDH status was known in 75,2% of astrocytic tumours. The rate of correct integrated diagnoses varies from 47,6% to 56,4% among different gliomas. MGMTp methylation status is available in 32,2% of glioblastomas. Conclusion: Both the integration of molecular markers in the conclusion of the pathology reports and the delivery of those reports to the BCR can be improved. The availability of distinct ICD-O-3 codes for each molecularly defined tumour entity within the WHO classification would increase the consistency of cancer registration, facilitate population level research and international benchmarking.

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“…Use of corticosteroids for cerebral edema and symptom management can be very beneficial but is also associated with decreased survival. 56 Moreover, steroid-related complications such as insomnia, mood and appetite changes, infections, increased GI acidity, steroid myopathy, hyperglycemia, and avascular necrosis are commonly observed. Neurologists can help their colleagues minimize steroid exposure in these patients, which should be used only for the relief of focal neurologic symptoms for which no other treatment is effective.…”

Section: Discussionmentioning

confidence: 99%

“…Neurologists can help their colleagues minimize steroid exposure in these patients, which should be used only for the relief of focal neurologic symptoms for which no other treatment is effective. 56 Additional coordination of care teams should include psychologists, physical, occupational, speech, and swallow therapists who can provide significant benefit to people with gliomas and their caregivers. Lastly, early involvement of palliative care teams has been proven to improve quality of life and sometimes OS in other cancers and is recommended for all glioma patients as part of an active multidisciplinary treatment plan.…”

Section: Discussionmentioning

confidence: 99%

Neuro-oncology Treatment Strategies for Primary Glial Tumors

Santos-Pinheiro,

Graber

2023

Semin Neurol

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Primary brain tumors underwent reclassification in the 2021 World Health Organization update, relying on molecular findings (especially isocitrate dehydrogenase mutations and chromosomal changes in 1p, 19q, gain of chromosome 7 and loss of chromosome 10). Newer entities have also been described including histone 3 mutant midline gliomas. These updated pathologic classifications improve prognostication and reliable diagnosis, but may confuse interpretation of prior clinical trials and require reclassification of patients diagnosed in the past. For patients over seventy, multiple studies have now confirmed the utility of shorter courses of radiation, and the risk of post-operative delirium. Ongoing studies are comparing proton to photon radiation. Long term follow up of prior clinical trials have confirmed the roles and length of chemotherapy (mainly temozolomide) in different tumors, as well as the wearable novottf device. New oral isocitrate dehydrogenase inhibitors have also shown efficacy in clinical trials.

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Quality indicators in neuro-oncology: Review of the literature and development of a new quality indicator set for glioma care through a two-round Delphi survey

Cited by 3 publications

References 30 publications

Editorial: Quality of care of glioma patients

Editorial: Quality of care of glioma patients

Cancer Registration, Molecular Marker Status, and Adherence to the WHO 2016 Classification of Pathology Reports for Glioma Diagnosed during 2017–2019 in Belgium

Neuro-oncology Treatment Strategies for Primary Glial Tumors

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