{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T19:50:04Z","timestamp":1772999404189,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"15","license":[{"start":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T00:00:00Z","timestamp":1754352000000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100012524","name":"American Lebanese Syrian Associated Charities","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012524","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The global incidence of childhood cancer is rising, with nearly 90% of cases occurring in low\u2010 and middle\u2010income countries (LMICs), where mortality remains high due to limited access to quality pediatric surgical care. To address this, the International Society of Pediatric Surgical Oncology (IPSO) and St. Jude Children's Research Hospital developed the Pediatric Oncology Facility Integrated Local Evaluation Surgical Tool (PrOFILE\u2010ST) to assess surgical capacity and quality in resource\u2010limited settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PrOFILE\u2010ST was developed in three stages: construction, content validation, and pilot testing. The tool was refined over three years through biweekly team meetings and expert feedback. Pilot testing took place at six institutions across five countries (Sudan, Zambia, Peru, Mexico, Brazil), collecting both quantitative and qualitative data on surgical practices. Data was analyzed using descriptive statistics, producing reports to guide quality improvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The final tool consists of 12 modules and 273 questions. Pilot testing revealed differences in surgical capacity between upper\u2010middle\u2010income countries (UMICs) and lower middle\/low\u2010income countries (LMICs\/LICs). UMICs had better infrastructure, while LMICs\/LICs excelled in surgical reporting and timeliness. Improvement priorities included the development of pediatric surgical oncology fellowships, standardization of operative reporting, systematic morbidity and mortality analysis, and establishment of real\u2010time multidisciplinary team discussions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PrOFILE\u2010ST is an effective tool for assessing pediatric oncology surgery across diverse settings, highlighting strengths and areas for improvement. It can guide quality improvement efforts to address global disparities in childhood cancer outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.71122","type":"journal-article","created":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T11:44:56Z","timestamp":1754394296000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and Pilot Testing of\n                    <scp>PrOFILE<\/scp>\n                    \u2010\n                    <scp>ST<\/scp>\n                    : A Pediatric Surgical Oncology Capacity and Quality Assessment Tool for Resource\u2010Limited Settings"],"prefix":"10.1002","volume":"14","author":[{"given":"Fernanda Kelly Marques","family":"de Souza","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery Pediatric Oncology Institute \u2010 GRAACC \u2010 Federal University of S\u00e3o Paulo  S\u00e3o Paulo 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