2026 Poster Presentations
P454: CENTER OF EXCELLENCE FOR THE SURGICAL AND CLINICAL MANAGEMENT OF BRAIN AND SKULL BASE TUMORS IN A LATIN AMERICAN HEALTHCARE INSTITUTION: DEVELOPMENT AND IMPLEMENTATION
Silvia Quintero, MD; Jorge Luis Molina, MD; Clinica Medilaser
Introduction: Our institution is located in a mid-sized city in Colombia. One year ago, we began efforts to standardize the care of patients with brain and skull base tumors. Our institution made a significant investment in surgical instruments and equipment, which enabled us to perform all types of procedures, including those of the highest complexity. Complementary to this, we formed a transdisciplinary team composed of specialists in medical oncology, radiation oncology, endocrinology, neuroradiology, bioethics, social work, psychology, rehabilitation, and neurosurgery. The team is led by a neurosurgeon with formal training in neuro-oncology and skull base surgery, who is fully dedicated to the management of these complex pathologies.
Objective: To describe the outcomes of the first year of implementation of the Center of Excellence. We aim to highlight the challenges and obstacles encountered during this process, as well as the clinical, surgical, and organizational benefits observed.
Methods: In August 2024, our institution officially launched the development of a Center of Excellence for the management of brain and skull base tumors. This study includes all patients enrolled in the program during its first year. We documented and analyzed clinical and surgical outcomes, along with administrative, academic, and financial aspects encountered during the implementation phase.
Results: A total of 72 patients were included in the program. The most common tumors were meningiomas in various locations (16 cases), followed closely by pituitary neuroendocrine tumors (15 cases) and glial tumors (15 cases). Less frequently, we observed brain metastases, intraventricular tumors, and, more rarely, pineal region tumors. We achieved 100% postoperative follow-up with the same neurosurgeon for at least one visit. The complication and mortality rates within the first postoperative month did not exceed 5%. However, we face significant challenges in long-term follow-up. Our center is located in a remote area of the country, most patients come from low socioeconomic backgrounds, and the current healthcare system is not designed to support the operation of high-standard centers. As a result, many patients are unable to remain enrolled in the program.
Conclusions: The implementation of Centers of Excellence for the surgical and clinical management of brain and skull base tumors is essential in Latin American countries. Given the low incidence of these conditions, it is difficult to achieve an adequate learning curve without a structured, high-volume, multidisciplinary approach. These centers represent a promising strategy to improve patient outcomes and optimize the healthcare system’s response to complex neurosurgical diseases. Furthermore, the program has fostered a more humane and ethically responsible approach to care, offering patients emotional reassurance and a dignified treatment experience.