The Current Landscape of Neurosurgical Oncology in Low-Middle-Income Countries (LMIC): Strategies for the Path Forward

Tirone Young, Maria Pia Tropeano, Delia Cannizzaro, Alice J.M. Jelmoni, Franco Servadei, Isabelle M. Germano

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Objective: To promote global equity in research, innovation, and care, sharing knowledge and grasping current benchmarks is crucial. Despite LIC/LMIC constituting around 80% of the global population, their contribution to neurosurgery research is less than 5%. This study aims to assess the status of neurosurgical oncology in LIC/LMIC using published data, offering strategic insights for progress. Methods: Conducting a retrospective bibliometric analysis via PubMed and Scopus databases, we documented reports published (2015–2021) by neurosurgical department-affiliated investigators in LICs/LMICs. World Bank classifications identified LIC and LMIC. Reviewed papers underwent further scrutiny based on independent and associated keyword lists. Results: Our systematic approach revealed 189 studies from LMIC in 10 neurosurgery journals. Of these, 53% were case reports, with 88% focusing on brain pathologies and 12% on the spine. Intra-axial brain tumors (45.8%), extra-axial/skull base (38.4%), and metastasis (3.68%) were prominent. Among noncase report publications, surgical technique and outcome were common themes. India, Egypt, and Tunisia led in publications, with 94% appearing in journals with an impact factor below 5. No papers originated from LIC. Conclusions: This study reinforces existing findings that data from LMIC inadequately represent their populations, impeding a comprehensive understanding of their neurosurgical oncology landscape. Language barriers and data collection difficulties contribute to this gap. Addressing these challenges could significantly enhance progress in shaping the future of neurosurgical oncology in these regions.

Original languageEnglish
Pages (from-to)e291-e298
JournalWorld Neurosurgery
StatePublished - Apr 2024


  • Global health
  • Low-and middle-income country
  • Low-income country
  • Neurosurgery
  • Neurosurgical oncology


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