INNV-34. Capacity building in pediatric surgical neuro-oncology: assessment of clinical collaborations within limited resources in a low middle income country

Abstract BACKGROUND AND OBJECTIVE Pediatric brain tumors require specialized multidisciplinary care. In many low- and middle-income countries (LMICs), including Pakistan, access to pediatric neuro-oncology expertise is limited due to a shortage of trained specialists. Collaborative models, such as involving visiting consultants, may help improve diagnosis, treatment, and outcomes. To date, no study from Pakistan has assessed the role of such collaborations in pediatric neuro-oncology. This study aimed to analyze the impact of a visiting consultant pediatric neuro-oncologist on the outcomes of pediatric patients with brain tumors in a healthcare system with no in-house pediatric neuro-oncologist. METHODOLOGY This retrospective study was conducted at the Punjab Institute of Neurosciences from January 2023 to January 2025. It included pediatric patients with brain tumors who were evaluated by a visiting pediatric neuro-oncologist. These patients were followed for one year to monitor surgical interventions, referrals, and clinical outcomes. RESULTS A total of 45 pediatric patients were assessed by the visiting pediatric neuro-oncologist. Among them, 82.22% (n=37) underwent craniotomy and excision, while 8.89% (n=4) had a biopsy. On histopathological examination, the most common tumor type was glioma, found in 37.78% (n=17) of patients. Based on the consultant’s evaluation, 24.44% (n=11) of patients were referred for adjuvant therapy. At one-year follow-up, 90.63% of patients were healthy without any new neurological deficits, and 28.89% (n=13) were lost to follow-up. CONCLUSION In countries with limited resources and few pediatric neuro-oncology specialists, collaboration through visiting consultants can significantly improve the care, management, and outcomes of children with brain tumors. This approach may serve as a practical model for capacity building in pediatric surgical neuro-oncology in low- and middle-income countries.