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Peer-reviewedCC BY-NC 4.0Journal of Korean Neurosurgical Society

Understanding Practice Variations in the Management of Central Nervous System Germ Cell Tumours : Insights from the NUGA Survey

  • Ru-Xin Wong1
  • Kanjana Shotelersuk2
  • Bongkot Jia-Mahasap3
  • Warissara Ronthong4
  • Jen-Chun Foo5
  • Dharmendra Ganesan6
  • Nisha Shariff7
  • Kyung-Nam Koh8
  • Tsz Yeung Kam9
  • Ronnie Baticulon10
  • Cherry Villar11
  • Felicia H. Z. Chua12
5 more authors
  • Yusuke Demizu13
  • Tai-Tong Wong14
  • Dong-Eun Lee15
  • Yen-Lin Liu16
  • Joo-Young Kim17
17 affiliations
  1. 1Icon Cancer Centre, Singapore
  2. 2Division of Radiation Oncology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
  3. 3Division of Radiation Oncology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
  4. 4Division of Radiation Oncology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
  5. 5University Malaya Medical Centre, Kuala Lumpur, Malaysia
  6. 6Department of Surgery, University of Malaya, Kuala Lumpur, Malaysia
  7. 7University (MCO) Malaya Medical Centre, Kuala Lumpur, Malaysia
  8. 8Division of Paediatric Haematology/Oncology, Department of Paediatrics, Asan Medical Centre Children’s Hospital, University of Ulsan College of Medicine, Seoul, Korea
  9. 9Department of Clinical Oncology, Prince of Wales Hospital, Hong Kong, China
  10. 10Philippine General Hospital University, Manila, Philippines
  11. 11Philippine Children’s Medical Centre, Manila, Philippines
  12. 12Neurosurgical Service, KK Women’s and Children’s Hospital, Singapore, Singapore
  13. 13Department of Radiation Oncology, Hyogo Ion Beam Medical Centre Kobe Proton Centre, Hyogo, Japan
  14. 14Taipei Cancer Centre, School of Medicine, Taipei Medical University, Taipei, Taiwan
  15. 15Division of Cancer Epidemiology and Management, Research Institute, National Cancer Centre, Goyang, Korea
  16. 16Department of Paediatrics, Taipei Medical University Hospital, School of Medicine, Colleage of Medicine, Taipei Medical University, Taipei, Taiwan
  17. 17Department of Radiation Oncology, Research Institute and Hospital, National Cancer Centre, Goyang, Korea
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Abstract

Objective: Central nervous system germ cell tumours (CNS GCTs) are more prevalent in Asia than in Western populations. Treatment approaches remain heterogeneous across different Asian countries.

Methods: Following a physical meeting of Asian specialists in Seoul in September 2024, an on-site and electronic survey was conducted among Asian specialists within the NeUro Germ cell Asia network to assess practice patterns and identify areas requiring consensus.

Results: Forty-two specialists from eight Asian countries participated. Findings highlight the need for an Asian consortium to standardize management. Key variations were noted in age stratification, necessity of biopsy, tumour marker cut-offs, classification of bifocal disease and management of basal ganglia tumours, the role of chemotherapy in germinomas, and radiotherapy dose and volume for non-germinomatous germ cell tumours (NGGCTs).

Conclusion: This survey identifies substantial practice variation in CNS GCT management across Asia. Priority areas requiring consensus include biopsy indications, tumour marker interpretation, age-adapted treatment strategies, the role of radiotherapy alone in adolescent and young adult germinoma, and optimisation of chemotherapy and radiotherapy approaches for NGGCT.

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Cite

BibTeXRIS
BibTeX
@article{wong2026understanding,
  title = {{Understanding Practice Variations in the Management of Central Nervous System Germ Cell Tumours : Insights from the NUGA Survey}},
  author = {Ru-Xin Wong and Kanjana Shotelersuk and Bongkot Jia-Mahasap and Warissara Ronthong and Jen-Chun Foo and Dharmendra Ganesan and Nisha Shariff and Kyung-Nam Koh and Tsz Yeung Kam and Ronnie Baticulon and Cherry Villar and Felicia H. Z. Chua and Yusuke Demizu and Tai-Tong Wong and Dong-Eun Lee and Yen-Lin Liu and Joo-Young Kim},
  journal = {Journal of Korean Neurosurgical Society},
  year = {2026},
  month = oct,
  doi = {10.3340/jkns.2026.0025},
  url = {https://doi.org/10.3340/jkns.2026.0025},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - Understanding Practice Variations in the Management of Central Nervous System Germ Cell Tumours : Insights from the NUGA Survey
AU  - Ru-Xin Wong
AU  - Kanjana Shotelersuk
AU  - Bongkot Jia-Mahasap
AU  - Warissara Ronthong
AU  - Jen-Chun Foo
AU  - Dharmendra Ganesan
AU  - Nisha Shariff
AU  - Kyung-Nam Koh
AU  - Tsz Yeung Kam
AU  - Ronnie Baticulon
AU  - Cherry Villar
AU  - Felicia H. Z. Chua
AU  - Yusuke Demizu
AU  - Tai-Tong Wong
AU  - Dong-Eun Lee
AU  - Yen-Lin Liu
AU  - Joo-Young Kim
PY  - 2026
DA  - 2026/10/22
JO  - Journal of Korean Neurosurgical Society
DO  - 10.3340/jkns.2026.0025
UR  - https://doi.org/10.3340/jkns.2026.0025
AB  - Objective: Central nervous system germ cell tumours (CNS GCTs) are more prevalent in Asia than in Western populations. Treatment approaches remain heterogeneous across different Asian countries.  Methods: Following a physical meeting of Asian specialists in Seoul in September 2024, an on-site and electronic survey was conducted among Asian specialists within the NeUro Germ cell Asia network to assess practice patterns and identify areas requiring consensus.  Results: Forty-two specialists from eight Asian countries participated. Findings highlight the need for an Asian consortium to standardize management. Key variations were noted in age stratification, necessity of biopsy, tumour marker cut-offs, classification of bifocal disease and management of basal ganglia tumours, the role of chemotherapy in germinomas, and radiotherapy dose and volume for non-germinomatous germ cell tumours (NGGCTs).  Conclusion: This survey identifies substantial practice variation in CNS GCT management across Asia. Priority areas requiring consensus include biopsy indications, tumour marker interpretation, age-adapted treatment strategies, the role of radiotherapy alone in adolescent and young adult germinoma, and optimisation of chemotherapy and radiotherapy approaches for NGGCT.
SN  - 2005-3711
SN  - 1598-7876
ER  -