As Nation Focuses on Reforming Healthcare, Neurosurgeons Release the First Evidence-Based, Multidisciplinary Treatment Guidelines for Brain Metastases Patients

Recent Explosion in New Technology and Increased Treatment Options Led to Need
for Uniform Guidance to Medical Providers
NEW ORLEANS--(Business Wire)--
While the nation is debating how best to reform healthcare, the American
Association of Neurological Surgeons(AANS) and Congress of Neurological Surgeons
(CNS) announce a new significant tool to improve the quality of care for
patients who suffer from brain tumors. The nation`s neurosurgeons have released
the first national formal evidence-based, multidisciplinary treatment guidelines
for patients with brain metastases, which account for nearly 500,000 new cancers
annually in the United States. Brain metastases are tumors which travel to the
brain from other areas of the body, usually the breast or lung and outnumber all
other brain tumors combined by more than four to one.

The guidelines - which were released today at the Congress of Neurological
Surgeons 2009 Annual Meeting in New Orleans - were developed over the last year
by a 20-member panel in various specialties in conjunction with the McMasters
Evidence-based Practice Center, which is world-renowned for its seminal work in
evidence-based medicine (EBM). The formal EBM process involved reviewing the
literature and reaching a multidisciplinary consensus for different treatments.
Unlike previous formal expert consensus efforts, recommendations are directly
linked to levels of evidence in a transparent and reproducible methodology.
Members of the panel analyzed 25,000 studies and then utilized 400 of them to
make their final guideline decisions. The panel was headed by neurosurgeon
Steven Kalkanis, MD, co-director of the Hermelin Brain Tumor Center at Henry
Ford Hospital in Detroit and member of the AANS/CNS Joint Guidelines Committee.

Dr. Kalkanis explains the need for these significant treatment guidelines, "Over
the last decade, largely due to advances in technology, there has been an
explosion of new treatments for brain metastases, including: surgical resection,
stereotactic radiosurgery, whole brain radiation therapy, partial brain
radiation, chemotherapy and various combinations of all the above. Until now,
there hasn`t been a uniform, accepted way among physicians in how to treat these
patients. And most importantly, there hasn`t been a central source on which
treatment regimens give the best results. Since these new guidelines are based
on best-available evidence, it eliminates any bias and simply answers, `What
does the data support?`"

Of the 1.4 million individuals with cancer in 2008, 30 to 40 percent will
develop brain metastasis compared to the approximately 17,000 new cases annually
of primary malignant brain tumors, cancers that originate in the brain. "Our
primary goal with these new guidelines was to identify best treatment practices
leading to the best outcomes for patients," adds Dr. Kalkanis. "And we went a
step further, in cases where there was not enough data to suggest a guideline or
recommendation for a particular treatment, we listed all of the relevant ongoing
clinical trials in our report, as well as needed future studies, to inform the
medical community and to foster support for continuing this important research."

The new brain metastases guidelines include:

* A range of therapeutic options for treating brain metastases;
* The existing evidence used to guide decision-making and its limitations;
* The range of diversity in practice patterns and the various demographic
factors that influence clinical decisions; and
* The impact of expert reviews of published clinical evidence on practice
regarding treatment options for brain metastases.

This strict evidenced-based protocol was endorsed by not only the Congress of
Neurological Surgeons and American Association of Neurological Surgeons, but
also by the AANS/CNS Joint Tumor Section as well as experts from a wide range of
multidisciplinary fields, including: radiation oncology, medical oncology and
neuro-oncology, and neurosurgery.

"Neurosurgeons took the lead on this because we are the final common pathway for
treating these patients; they`re often referred to us as the last hope,"
comments Dr. Kalkanis. "Since these patients come to us from many different
directions, yet they all share the same diagnosis, we think it`s important that
all health care providers are at the same table with a common plan for how to
best treat these patients and improve their odds of survival."

Dr. Kalkanis concludes, "In this era of healthcare reform, the focus is on
better quality of care and better outcomes and on evidence-based medicine. For
brain metastases patients, there`s been a real shift in the paradigm in the last
10-15 years. Back then, patients died from brain metastases, but now, due to
more aggressive treatments and better tools, increased research, and many other
factors, it`s no longer a death sentence. It gives some hope to patients. We now
know what to do to lead to good results so now we need a common set of
guidelines to pull it all together. We`ve now provided that to the medical
community and it really raises the bar for patients."

The new guidelines will be published in a special issue of the Journal of
Neuro-Oncology in December.

Editor`s Note: Dr. Steven Kalkanis is available for interviews.

The American Association of Neurological Surgeons (AANS), founded in 1931, and
the Congress of Neurological Surgeons (CNS), founded in 1951, are the two
largest scientific and educational associations for neurosurgical professionals
in the world. These groups represent approximately 7,600 neurosurgeons
worldwide. Neurological surgery is the medical specialty concerned with the
prevention, diagnosis, treatment and rehabilitation of disorders that affect the
entire nervous system, including the spinal column, spinal cord, brain and
peripheral nerves. For more information, please visit www.aans.org or
www.cns.org.

American Association of Neurological Surgeons (AANS)
Susanne Hartman, 202-446-2028
shartman@neurosurgery.org

Copyright Business Wire 2009