Toward a transitional care from childhood and adolescence to adulthood in surgical neurooncology? A lesson from the Necker-Enfants Malades and the Sainte-Anne Hospitals collaboration

Alexandre Roux MD, MSc1,2,3, Kévin Beccaria MD, PhD2,4, Thomas Blauwblomme MD, PhD2,4, Nizar Mahlaoui MD, PhD5,6, Fabrice Chretien MD, PhD2,7, Pascale Varlet MD, PhD2,3,7, Stéphanie Puget MD, PhD2,4, and Johan Pallud MD, PhD1,2,3
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  • 1 Service de Neurochirurgie, GHU Paris—Hôpital Sainte-Anne, Paris;
  • | 2 Université de Paris, Sorbonne Paris Cité, Paris;
  • | 3 INSERM UMR 1266, IMA-Brain, Institut de Psychiatrie et Neurosciences de Paris;
  • | 4 Service de Neurochirurgie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, Paris
  • | 5 Centre de référence déficits immunitaires héréditaires (Ceredih), Hôpital universitaire Necker-Enfants malades, AP-HP, Paris; Unité d’immuno-hématologie et rhumatologie pédiatrique, Hôpital universitaire Necker-Enfants malades, AP-HP, Paris;
  • | 6 La Suite, Hôpital universitaire Necker-Enfants malades, AP-HP, Paris; and
  • | 7 Service de Neuropathologie, GHU Paris—Hôpital Sainte-Anne, Paris, France
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OBJECTIVE

Transitional care in surgical neurooncology is poorly studied. However, this period is pivotal, since it allows the patient to be empowered in his or her disease management. Here, the authors describe the experience of the Necker-Enfants Malades and the Sainte-Anne Hospital collaboration.

METHODS

The mixed transitional consultations started in September 2019 in a dedicated space for transitional care, named the “La Suite” department, located in the Necker-Enfants Malades Hospital, Paris, France. The authors organized planned consultations to schedule the clinical and radiological follow-up in the adult neurosurgical department but also emergency consultations to manage tumor recurrence in young adult patients. Transitional care was performed jointly by pediatric and adult neurosurgeons who have developed clinical and research skills in the field of surgical neurooncology. Neuropathological analysis was performed by a neuropathologist who is specialized in pediatric and adult neurooncology.

RESULTS

Fourteen patients benefited from a mixed transitional consultation. All of them accepted to start their management in an adult neurosurgical environment. Eleven patients (78.6%) for whom the disease was controlled benefited from a planned consultation. Three patients (21.4%) required rapid neurosurgical management for a tumor recurrence (n = 2) or for a new primary CNS tumor (n = 1) and benefited from an emergency consultation.

CONCLUSIONS

For adult patients harboring a brain tumor during childhood or adolescence, the authors suggest that neurosurgeons specialized in adult surgical neurooncology with a full knowledge in pediatric neurooncology will combine the required skills to optimize care management for these patients within a dedicated multidisciplinary organization framework.

ABBREVIATIONS

AYA = adolescent and young adult; NICE = National Institute for Health and Clinical Excellence; PCNST = primary CNS tumor.

Image from Mavridis et al. (pp 404–415).

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  • 1

    Louis DN, Perry A, Reifenberger G, et al. The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol. 2016;131(6):803820.

    • Search Google Scholar
    • Export Citation
  • 2

    Tallen G, Resch A, Calaminus G, et al. Strategies to improve the quality of survival for childhood brain tumour survivors. Eur J Paediatr Neurol. 2015;19(6):619639.

    • Search Google Scholar
    • Export Citation
  • 3

    Gajjar A, Bowers DC, Karajannis MA, et al. Pediatric brain tumors: innovative genomic information is transforming the diagnostic and clinical landscape. J Clin Oncol. 2015;33(27):29862998.

    • Search Google Scholar
    • Export Citation
  • 4

    Grill J, Puget S, De Carli E, et al. Childhood cerebral tumors: morbidity and follow-up into adulthood. Article in French. Neurochirurgie. 2008;54(5):623641.

    • Search Google Scholar
    • Export Citation
  • 5

    Vinchon M, Baroncini M, Leblond P, Delestret I. Morbidity and tumor-related mortality among adult survivors of pediatric brain tumors: a review. Childs Nerv Syst. 2011;27(5):697704.

    • Search Google Scholar
    • Export Citation
  • 6

    Roux A, Pallud J, Saffroy R, et al. High-grade gliomas in adolescents and young adults highlight histomolecular differences from their adult and pediatric counterparts. Neuro Oncol. 2020;22(8):11901202.

    • Search Google Scholar
    • Export Citation
  • 7

    Vinchon M, Dhellemmes P. The transition from childhood to adulthood in neurosurgery: a description. Article in French. Neurochirurgie. 2008;54(5):575582.

    • Search Google Scholar
    • Export Citation
  • 8

    American Academy of Pediatrics. A consensus statement on health care transitions for young adults with special health care needs. Pediatrics. 2002;110(6 Pt 2):13041306.

    • Search Google Scholar
    • Export Citation
  • 9

    Mahlaoui N, Langellier-Bellevue B. Les enjeux de la transition de la pédiatrie vers la médecine d’adultes. Soins Pediatr Pueric. 2017;38(297):1215.

    • Search Google Scholar
    • Export Citation
  • 10

    Seigneur É. Les spécificités de la transition en cancérologie pédiatrique. Soins Pediatr Pueric. 2017;38(297):2528.

  • 11

    Pombet T. La “double transition” des jeunes atteints de cancer. Soins Pediatr Pueric. 2017;38(297):1920.

  • 12

    National Institute for Health and Clinical Excellence. NICE Guidance on Cancer Services: Improving Outcomes for People with Brain and Other CNS Tumours: The Manual. National Institute for Health and Clinical Excellence; 2006.Accessed April 29, 2021.https://www.nice.org.uk/guidance/csg10/resources/improving-outcomes-for-people-with-brain-and-other-central-nervous-system-tumours-update-pdf-27841361437

    • Search Google Scholar
    • Export Citation
  • 13

    Frappaz D, Sunyach MP, Le Rhun E, et al. Adolescent and Young Adults (AYAS) brain tumor national Web conference. On behalf of ANOCEF, GO-AJA and SFCE societies. Article in French. Bull Cancer. 2016;103(12):10501056.

    • Search Google Scholar
    • Export Citation
  • 14

    Arora RS, Alston RD, Eden TOB, et al. Age-incidence patterns of primary CNS tumors in children, adolescents, and adults in England. Neuro Oncol. 2009;11(4):403413.

    • Search Google Scholar
    • Export Citation
  • 15

    Kieran MW, Walker D, Frappaz D, Prados M. Brain tumors: from childhood through adolescence into adulthood. J Clin Oncol. 2010;28(32):47834789.

    • Search Google Scholar
    • Export Citation
  • 16

    White PH, Cooley WC. Supporting the health care transition from adolescence to adulthood in the medical home. Pediatrics. 2018;142(5):e20182587.

    • Search Google Scholar
    • Export Citation
  • 17

    Campbell F, Biggs K, Aldiss SK, et al. Transition of care for adolescents from paediatric services to adult health services. Cochrane Database Syst Rev. 2016;4:CD009794.

    • Search Google Scholar
    • Export Citation
  • 18

    Boydell KM, Stasiulis E, Greenberg M, et al. I’ll show them: the social construction of (in)competence in survivors of childhood brain tumors. J Pediatr Oncol Nurs. 2008;25(3):164174.

    • Search Google Scholar
    • Export Citation
  • 19

    Ng S, Zouaoui S, Bessaoud F, et al. An epidemiology report for primary central nervous system tumors in adolescents and young adults: a nationwide population-based study in France, 2008-2013. Neuro Oncol. 2020;22(6):851863.

    • Search Google Scholar
    • Export Citation
  • 20

    Sommers BD, Buchmueller T, Decker SL, et al. The Affordable Care Act has led to significant gains in health insurance and access to care for young adults. Health Aff (Millwood). 2013;32(1):165174.

    • Search Google Scholar
    • Export Citation
  • 21

    Sommers BD, Kenney GM, Epstein AM. New evidence on the Affordable Care Act: coverage impacts of early Medicaid expansions. Health Aff (Millwood). 2014;33(1):7887.

    • Search Google Scholar
    • Export Citation
  • 22

    Akosa Antwi Y, Moriya AS, Simon KI. Access to health insurance and the use of inpatient medical care: evidence from the Affordable Care Act young adult mandate. J Health Econ. 2015;39:171187.

    • Search Google Scholar
    • Export Citation
  • 23

    Scott JW, Rose JA, Tsai TC, et al. Impact of ACA insurance coverage expansion on perforated appendix rates among young adults. Med Care. 2016;54(9):818826.

    • Search Google Scholar
    • Export Citation
  • 24

    Parsons HM, Schmidt S, Tenner LL, et al. Early impact of the Patient Protection and Affordable Care Act on insurance among young adults with cancer: analysis of the dependent insurance provision. Cancer. 2016;122(11):17661773.

    • Search Google Scholar
    • Export Citation
  • 25

    Stagno V, Mugamba J, Ssenyonga P, et al. Presentation, pathology, and treatment outcome of brain tumors in 172 consecutive children at CURE Children’s Hospital of Uganda. The predominance of the visible diagnosis and the uncertainties of epidemiology in sub-Saharan Africa. Childs Nerv Syst. 2014;30(1):137146.

    • Search Google Scholar
    • Export Citation
  • 26

    Riaz Q, Naeem E, Fadoo Z, et al. Intracranial tumors in children: a 10-year review from a single tertiary health-care center. Childs Nerv Syst. 2019;35(12):23472353.

    • Search Google Scholar
    • Export Citation
  • 27

    Hadley LGP, Rouma BS, Saad-Eldin Y. Challenge of pediatric oncology in Africa. Semin Pediatr Surg. 2012;21(2):136141.

  • 28

    Khan UA, Bhavsar A, Asif H, et al. Treatment by specialist surgical neurooncologists improves survival times for patients with malignant glioma. J Neurosurg. 2015;122(2):297302.

    • Search Google Scholar
    • Export Citation
  • 29

    Albright AL, Sposto R, Holmes E, et al. Correlation of neurosurgical subspecialization with outcomes in children with malignant brain tumors. Neurosurgery. 2000;47(4):879887.

    • Search Google Scholar
    • Export Citation

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