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Background <p>The impact of neurosurgical subspecialization on long-term multidimensional outcomes in glioma patients remains poorly explored.</p> Objective <p>To examine the association between subspecialized care and overall survival, interval survival, hospital stay, quality of life, functional recovery, and work ability in glioma patients.</p> Methods <p>We conducted a retrospective analysis of 2006 glioma patients who underwent resection at Huashan Hospital (2010–2018). Surgeons were categorized as subspecialists or non-subspecialists. Propensity score matching (PSM) was used to balance baseline characteristics. Outcomes included overall survival (OS), disability-adjusted life years (DALYs), functional recovery (≥ 10-point improvement in KPS), and work ability recovery. Statistical analyses employed Kaplan-Meier methods, piecewise survival analysis, restricted mean survival time (RMST), and subgroup analyses according to the 2021 WHO classification.</p> Results <p>After matching, the subspecialty group had significantly shorter hospitalization (15.00 vs. 17.00 days, <i>p</i> &lt; 0.001). Piecewise survival analysis suggested improved survival in the subspecialty group during 0–27 and 30–48 months postoperatively (both <i>p</i> &lt; 0.01). Functional recovery appeared to be better in the subspecialty group, with 72.3% achieving KPS improvement vs. 62.6% in the non-subspecialty group (<i>p</i> &lt; 0.001). No significant differences were found in DALYs or work ability recovery.</p> Conclusion <p>Subspecialized care is associated with shorter hospitalization, mid-term survival benefits, and improved functional recovery in glioma patients. These findings suggest that subspecialization may be a relevant organizational factor in neuro-oncologic surgery.</p>

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Structural organization of neurosurgical care and its influence on long-term outcomes in glioma: evidence from a large single-center cohort in China

  • 期刊论文

  • 发表日期：

    2026年4月20日

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  • Tian Gan,
  • Mai Li,
  • Jie Zhang,
  • Ye Yao

摘要

Background

The impact of neurosurgical subspecialization on long-term multidimensional outcomes in glioma patients remains poorly explored.

Objective

To examine the association between subspecialized care and overall survival, interval survival, hospital stay, quality of life, functional recovery, and work ability in glioma patients.

Methods

We conducted a retrospective analysis of 2006 glioma patients who underwent resection at Huashan Hospital (2010–2018). Surgeons were categorized as subspecialists or non-subspecialists. Propensity score matching (PSM) was used to balance baseline characteristics. Outcomes included overall survival (OS), disability-adjusted life years (DALYs), functional recovery (≥ 10-point improvement in KPS), and work ability recovery. Statistical analyses employed Kaplan-Meier methods, piecewise survival analysis, restricted mean survival time (RMST), and subgroup analyses according to the 2021 WHO classification.

Results

After matching, the subspecialty group had significantly shorter hospitalization (15.00 vs. 17.00 days, p < 0.001). Piecewise survival analysis suggested improved survival in the subspecialty group during 0–27 and 30–48 months postoperatively (both p < 0.01). Functional recovery appeared to be better in the subspecialty group, with 72.3% achieving KPS improvement vs. 62.6% in the non-subspecialty group (p < 0.001). No significant differences were found in DALYs or work ability recovery.

Conclusion

Subspecialized care is associated with shorter hospitalization, mid-term survival benefits, and improved functional recovery in glioma patients. These findings suggest that subspecialization may be a relevant organizational factor in neuro-oncologic surgery.