ID #882 Closing the Survival Gap: A Five-Year National Strategy for Multidisciplinary Remote Care of Paediatric Brain Tumours in Argentina

Introduction Pediatric central nervous system (CNS) tumors account for approximately 260 annual diagnoses in Argentina. Despite a significant mortality reduction at the national reference center, Hospital Garrahan (61.8% in 2000 to 32.4% in 2018), these gains remained geographically heterogeneous. This disparity led to a 62% patient migration rate for specialized care. Consequently, a multidisciplinary remote network was established in December 2020 to mitigate these systemic inequities and decentralize subspecialized expertise. Methods Biweekly synchronous virtual tumor boards were established between Hospital Garrahan and regional units to standardize referral, staging, and therapeutic protocols. The multidisciplinary panel comprised neuro-oncologists, neurosurgeons, neuropathologists, neuroradiologists, and radiation therapists. In January 2026, the network’s utility was assessed via a voluntary, anonymous cross-sectional survey (n = 60) involving pediatric oncologists (n = 43), neurosurgeons (n = 11), and other specialists (n = 6). Results Over five years, the forum facilitated the expert review of 288 new CNS cases across 23 provinces, representing 98,6% of the national population. Centralized interventions proved decisive: secondary histopathological assessments resulted in diagnostic reclassification for 21% of cases, while neuroradiological re-evaluation prompted modifications to definitive treatment plans for [28.7]% of patients. Primary therapeutic optimizations involved chemotherapy modification (52,9%) and surgical timing (26,2%). Notably, physical transfer to high-complexity centers was limited to 18.6% of cases (primarily for radiotherapy, complex surgery, or autologous stem cell rescue). Survey data demonstrated robust engagement: 80% of participants presented at least 1 case, with 46.7% presenting 2–5 cases and 11.7% exceeding 10 presentations. Furthermore, 100% of participants reported satisfactory case resolution, with 96% identifying the forum as an “important” (30%) or “very important” (66.7%) instrument for daily clinical practice. Conclusion This telemedicine-based model effectively mitigates infrastructure disparities in developing regions. By ensuring diagnostic equity and therapeutic precision, this strategy provides a scalable framework for national health policy in complex medical disciplines.