KCMC-FCCT Tumor Board October 2023

The October tumor board was our first multidisciplinary neuro-oncology tumor board. Two cases of glioblastoma multiforme (GBM) were discussed. Development of a neuro-oncology program at KCMC was the vision of the late Dr Mark Jacobson. The program is a collaborative effort between KCMC, FCCT, the East African Medical Assistance Foundation (www.emaf.org) and the Barrow Neurologic Institute’s Global Program (www.barrowneuro.org/for-physicians-researchers/barrow-global/). The program includes neurosurgical expertise, high quality MRI imaging capability, appropriate neurosurgery equipment and now, multidisciplinary international tumor board case discussion.

Two recent reviews (Haizel-Cobbina et al and Aderinto, et al.) describe the landscape of neuro-oncology in East Africa and challenges to patient management (https://pubmed.ncbi.nlm.nih.gov/34468839/) (https://journals.lww.com/ijsgh/Fulltext/2023/05010/Navigating_the_challenges_of_neuro_oncology_in.8.aspx?context=LatestArticles). There is under-reporting of brain tumor cases due to lack of access to neurosurgical care and diagnostic expertise. There is a lack of neuro-oncology expertise and access to radiation therapy. Of note, one third of brain tumor cases reported in East Africa were pediatric. The development of the neurosurgery program at KCMC helps address the unmet need for neuro-oncology care.

Of the two cases of GBM discussed at the tumor board, one presented with severe neurologic symptoms and a classic “butterfly” glioma on MRI imaging. Symptoms and radiographic signs of brain stem herniation were present and unfortunately the patient died shortly after presentation. The second case involved a woman with a frontal parietal lesion; plans were made for resection which was previously unavailable in this region of Tanzania. In addition, a collaborative effort between FCCT, The Tanzania Ministry of Health, KCMC and USAID will bring radiation therapy capability to KCMC which will enhance brain tumor management.

Multidisciplinary tumor board discussion improves patient care and serves as a quality metric in the United States. Recently, Schroeder, et al have highlighted the importance of multi-disciplinary neuro-oncology tumor board case discussion on improving patient care at the Bugando Medical Center in the Mwanza District of Tanzania (https://aacrjournals.org/cebp/article/32/6_Supplement/54/726620/Abstract-54-Influence-of-Neuro-Oncology-Capacity).