Challenges and Opportunities in Accessing Surgery for Glioblastoma in Low–Middle Income Countries: A Narrative Review

Author:

Tini Paolo1,Rubino Giovanni1,Pastina Pierpaolo1,Chibbaro Salvatore23,Cerase Alfonso4ORCID,Marampon Francesco5,Paolini Sergio67,Esposito Vincenzo67,Minniti Giuseppe57ORCID

Affiliation:

1. Unit of Radiation Oncology, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy

2. Unit of Neurosurgery, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy

3. Neurosurgery Department, University of Strasbourg, 67000 Strasbourg, France

4. Unit of Neuroradiology, Azienda Ospedaliera Universitario Senese, 53100 Siena, Italy

5. Radiation Oncology, Policlinico Umberto I, Department of Radiological, Oncological and Pathological Sciences, “Sapienza” University of Rome, 00185 Rome, Italy

6. Department of Neuroscience, “Sapienza” University of Rome, 00185 Rome, Italy

7. IRCSS Neuromed, 86077 Pozzilli, Italy

Abstract

Glioblastoma: a highly aggressive brain tumor, presents substantial challenges in treatment and management, with surgical intervention playing a pivotal role in improving patient outcomes. Disparities in access to brain tumor surgery arise from a multitude of factors, including socioeconomic status, geographical location, and healthcare resource allocation. Low- and middle-income countries (LMICs) often face significant barriers to accessing surgical services, such as shortages of specialized neurosurgical expertise, limited healthcare infrastructure, and financial constraints. Consequently, glioblastoma patients in LMICs experience delays in diagnosis, suboptimal treatment, and poorer clinical outcomes compared to patients in high-income countries (HICs). The clinical impact of these disparities is profound. Patients in LMICs are more likely to be diagnosed at advanced disease stages, receive less effective treatment, and have lower survival rates than their counterparts in HICs. Additionally, disparities in access to surgical care exacerbate economic and societal burdens, emphasizing the urgent need for targeted interventions and health policy reforms to address healthcare inequities. This review highlights the importance of addressing global disparities in access to brain tumor surgery for glioblastoma through collaborative efforts, policy advocacy, and resource allocation, aiming to improve outcomes and promote equity in surgical care delivery for all glioblastoma patients worldwide.

Publisher

MDPI AG

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