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Multi-Institutional Modified Delphi For Genomics in Expert Consensus Survey of Genomic Testing for Anterior Skull Base Malignancies

Year: 2025
Type: article
Abstract: Objectives: The use of genomic testing for patients with anterior skull base malignancies has grown dramatically. There are no clear guidelines on indications for testing. As the literature on the subject is still in early stages, there is a need for expert consensus. We conducted a modified Delphi expert consensus process with high-volume North American cranial base surgical programs. Design Setting Participants: A modified Delphi consensus approach was used, following the method laid out by the American Academy of Otolaryngology-Head and Neck Surgery, and included 13 high-volume care centers. An otolaryngologist was appointed at each location to serve as the institutional representative. Main Outcome Measures: Participant responses to Delphi surveys were tabulated to determine consensus. Results: Thirteen teams responded comprising 23 otolaryngologists and 10 neurosurgeons. Overall, 11 of 12 institutions reported genomic testing to be fairly or easily available at their location, and 22 of 38 initial statements achieved consensus. Statements achieving consensus focused on primary and recurrent rare tumors without possibility of margin-negative resection, those with family history of anterior skull base malignancies, or rare tumors with distant metastasis. Statements regarding routine genomic sequencing or for primary tumors and cost of care did not achieve consensus. Conclusion: Expert multidisciplinary teams agreed on several appropriate settings for genomic sequencing in patients with anterior skull base malignancies, including recurrence, distant metastasis, and the inability to achieve a margin-negative resection. Further research is needed to explicitly clarify the role of genomic sequencing in this rare disease group.
DOI: 10.1055/a-2531-2230
Authors: Anirudh Saraswathula, Shreya Sriram, Corinna Levine, Nyall R. London, Shirley Y. Su, Mathew Geltzeiler, Sanjeet V. Rangarajan, Ian Witterick, Brian Thorp, Kathleen Kelly Gallagher, Kenneth Byrd, Ricardo Carrau, Waleed Abuzeid, Eric Wang, Carl Snyderman, Erin L. McKean
Institutions: Johns Hopkins University, Johns Hopkins Medicine, University of Miami, University of Miami Health System, The University of Texas MD Anderson Cancer Center, Oregon Health & Science University, University of Tennessee Health Science Center, University of Toronto, University of North Carolina at Chapel Hill, Baylor College of Medicine, Augusta University, The Ohio State University, University of Washington, University of Pittsburgh, University of Michigan, Michigan Medicine
Language: English
Subfield: Surgery
Field: Medicine
Open Access status: green
OpenAlex ID: W4408129376
FWCI:
Cites: 46
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Related to: 10