title: Consensus on the management of intracranial germ-cell tumours.
abstract: The management of intracranial germ-cell tumours is complex because of varied clinical presentations, tumour sites, treatments and outcomes, and the need for multidisciplinary input. Participants of the 2013 Third International CNS Germ Cell Tumour Symposium (Cambridge, UK) agreed to undertake a multidisciplinary Delphi process to identify consensus in the clinical management of intracranial germ-cell tumours. 77 delegates from the symposium were selected as suitable experts in the field and were invited to participate in the Delphi survey, of which 64 (83%) responded to the invitation. Invited participants represented multiple disciplines from Asia, Australasia, Europe, and the Americas. 38 consensus statements encompassing aspects of intracranial germ-cell tumour work-up, staging, treatment, and follow-up were prepared. To achieve consensus, statements required at least 70% agreement from at least 60% of respondents. Overall, 34 (89%) of 38 statements met consensus criteria. This international Delphi approach has defined key areas of consensus that will help guide and streamline clinical management of patients with intracranial germ-cell tumours. Additionally, the Delphi approach identified areas of different understanding and clinical practice internationally in the management of these tumours, areas which should be the focus of future collaborative studies. Such efforts should translate into improved patient outcomes.
authors.affiliation: Department of Paediatric Haematology and Oncology, Cambridge University Hospitals NHS Trust, Cambridge, UK.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Murray
authors.affiliation: Pediatric Brain Tumour Program, Hospital for Sick Children, Toronto, ON, Canada.
authors.forename: Ute
authors.initials: U
authors.lastname: Bartels
authors.affiliation: Department of Neuro-Oncology/Neurosurgery, Saitama Medical University International Medical Centre, Hidaka, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Nishikawa
authors.affiliation: Department of Pediatric Hematology/Oncology, Neuro-Oncology and Stem Cell Transplantation, Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, IL, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Fangusaro
authors.affiliation: Department of Neuro-Oncology/Neurosurgery, Saitama Medical University International Medical Centre, Hidaka, Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Matsutani
authors.affiliation: Department of Paediatric Haematology and Oncology, Cambridge University Hospitals NHS Trust, Cambridge, UK. Electronic address: james.nicholson@addenbrookes.nhs.uk.
authors.forename: James C
authors.initials: JC
authors.lastname: Nicholson
mesh_terms: D001208:Asia; D044362:Australasia; D001932:Brain Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D003697:Delphi Technique; D019468:Disease Management; D005060:Europe; D006801:Humans; D009373:Neoplasms, Germ Cell and Embryonal / Q000453:epidemiology / Q000473:pathology / Q000628:therapy*