Surgical outcomes of glioblastoma multiforme in low and middle-income countries: current state and future directions

Abstract

Glioblastoma (GBM) is a highly aggressive and deadly brain tumor. The challenges in managing GBM in low- and middle-income countries (LMICs) have been underexplored. This review provides a review of surgical management techniques, challenges, outcomes, and future directions for GBM treatment in LMICs. A search of academic databases yielded studies from various LMICs, focusing on surgical management techniques and their outcomes. The data were analyzed in the context of socio-economic, cultural, and infrastructural factors. Comparative analyses were performed to highlight disparities between LMICs and high-income countries. GBM management in LMICs faces multi-faceted challenges, including healthcare infrastructure deficiencies, delayed diagnosis, high treatment costs, cultural beliefs, and limited research funding. This adversely affects patient outcomes and survival rates. Surgical excision followed by radiation and chemotherapy remains the standard of care, but LMICs have not significantly benefited from recent advancements in GBM management. Intraoperative neurosurgery ultrasound is identified as an affordable and practical alternative for LMICs. Patient outcomes following GBM surgery in LMICs vary widely, making early detection challenging. Cultural sensitivity and ethical considerations are crucial factors in improving healthcare practices. Surgical management of GBM in LMICs is hindered by complex challenges that require multi-faceted interventions. By addressing socio-economic, cultural, and infrastructural factors, LMICs can improve GBM care and outcomes. Raising awareness and advocating for change are crucial steps in this process.