Background: IDH-wild-type glioblastoma (GBM) is the most frequent brain-derived
malignancy. Despite intense research efforts, it is still associated with a very poor
prognosis. Several parameters were identified as prognostic, including general physical
performance. In neuro-oncology (NO), special emphasis is put on focal deficits and
cognitive (dys-)function. The Neurologic Assessment in Neuro-Oncology (NANO) scale
was proposed in order to standardize the assessment of neurological performance in NO.
This study evaluated whether NANO scale assessment provides prognostic information in
a standardized collective of GBM patients.
Methods: The records of all GBM patients treated between 2014 and 2019 at our facility
were retrospectively screened. Inclusion criteria were age over 18 years, at least 3 months
postoperative follow-up, and preoperative and postoperative cranial magnetic resonance
imaging. The NANO scale was assessed pre- and postoperatively as well as at 3 months
follow-up. Univariate and multivariate survival analyses were carried to investigate the
prognostic value.
Results: One hundred and thirty-one patients were included. In univariate analysis, poor
postoperative neurological performance (HR 1.13, p = 0.004), poor neurological
performance at 3 months postsurgery (HR 1.37, p < 0.001), and neurological
deterioration during follow-up (HR 1.38, p < 0.001), all assessed via the NANO scale,
were associated with shorter survival. In multivariate analysis including other prognostic
factors such as the extent of resection, adjuvant treatment regimen, or age, NANO scale
assessment at 3 months postoperative follow-up was independently associated with
survival prediction (HR 1.36, p < 0.001). The optimal NANO scale cutoff for patient
stratification was 3.5 points.
Conclusion: Neurological performance assessment employing the NANO scale might
provide prognostic information in patients suffering from GBM.
| Identifer | oai:union.ndltd.org:DRESDEN/oai:qucosa:de:qucosa:84402 |
| Date | 30 March 2023 |
| Creators | Kaspar, Johannes, Wende, Tim, Fehrenbach, Michael Karl, Wilhelmy, Florian, Jähne, Katja, Frydrychowicz, Clara, Prasse, Gordian, Meixensberger, Jürgen, Arlt, Felix |
| Publisher | Frontiers Research Foundation |
| Source Sets | Hochschulschriftenserver (HSSS) der SLUB Dresden |
| Language | English |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, doc-type:article, info:eu-repo/semantics/article, doc-type:Text |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 2234-943X, 790458 |
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