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Published on: January 19, 2024
Glioma management and outcome in low-middle-income countries: a systematic review
Adam M Abdallah1, Atef F Hulliel2, Asem A Almomani3
1Neuro Oncology Surgery, Department of Surgery, King Hussein Cancer Center, Amman, Jordan.
Background:
Gliomas are the most common primary malignant brain tumors, yet evidence on their management and outcomes in low- and middle-income countries (LMICs) remains limited. Disparities in diagnostic capacity, treatment access, and healthcare infrastructure create unique challenges that are poorly characterized in the existing literature.
Method:
A systematic review was conducted following PRISMA guidelines and registered in PROSPERO (CRD420261359813). PubMed and Scopus were searched for studies reporting glioma management and outcomes in LMICs. Two independent reviewers performed screening, data extraction, and quality assessment using the Newcastle-Ottawa Scale.
Results:
Thirty studies comprising 3,463 patients from 17 low- and middle-income countries (LMICs) were included. Low-grade gliomas accounted for 62.6% of tumors, while high-grade gliomas represented 37.4%. Molecular profiling was reported in 26.7% of studies. LGGs showed significantly better outcomes than HGGs, with pooled 5-year OS rates of 87.8% and 21.9%, respectively.
Conclusion:
Glioma management in LMICs is characterized by limited access to adjuvant therapies, minimal molecular diagnostic integration, and heterogeneous survival outcomes that fall below standards achieved in high-income countries. Targeted investments in radiotherapy infrastructure, chemotherapy access, and molecular diagnostic capabilities are essential to reduce global disparities in neuro-oncological care.
Systematic Review Registration:
https://www.crd.york.ac.uk/PROSPERO, identifier CRD420261359813.
