The Prognostic Value of NANO Scale Assessment in IDH-Wild-Type Glioblastoma Patients

BackgroundIDH-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 emp...

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Autores principales:	Johannes Kasper, Tim Wende, Michael Karl Fehrenbach, Florian Wilhelmy, Katja Jähne, Clara Frydrychowicz, Gordian Prasse, Jürgen Meixensberger, Felix Arlt
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	GBM glioblastoma neuro-oncology neurological performance NANO scale Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/94775bf4170e40539cce2cad00e99203
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spelling	oai:doaj.org-article:94775bf4170e40539cce2cad00e992032021-12-02T05:36:01ZThe Prognostic Value of NANO Scale Assessment in IDH-Wild-Type Glioblastoma Patients2234-943X10.3389/fonc.2021.790458https://doaj.org/article/94775bf4170e40539cce2cad00e992032021-12-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fonc.2021.790458/fullhttps://doaj.org/toc/2234-943XBackgroundIDH-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.MethodsThe 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.ResultsOne 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.ConclusionNeurological performance assessment employing the NANO scale might provide prognostic information in patients suffering from GBM.Johannes KasperTim WendeMichael Karl FehrenbachFlorian WilhelmyKatja JähneClara FrydrychowiczGordian PrasseJürgen MeixensbergerFelix ArltFrontiers Media S.A.articleGBMglioblastomaneuro-oncologyneurological performanceNANO scaleNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENFrontiers in Oncology, Vol 11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	GBM glioblastoma neuro-oncology neurological performance NANO scale Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	GBM glioblastoma neuro-oncology neurological performance NANO scale Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Johannes Kasper Tim Wende Michael Karl Fehrenbach Florian Wilhelmy Katja Jähne Clara Frydrychowicz Gordian Prasse Jürgen Meixensberger Felix Arlt The Prognostic Value of NANO Scale Assessment in IDH-Wild-Type Glioblastoma Patients
description	BackgroundIDH-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.MethodsThe 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.ResultsOne 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.ConclusionNeurological performance assessment employing the NANO scale might provide prognostic information in patients suffering from GBM.
format	article
author	Johannes Kasper Tim Wende Michael Karl Fehrenbach Florian Wilhelmy Katja Jähne Clara Frydrychowicz Gordian Prasse Jürgen Meixensberger Felix Arlt
author_facet	Johannes Kasper Tim Wende Michael Karl Fehrenbach Florian Wilhelmy Katja Jähne Clara Frydrychowicz Gordian Prasse Jürgen Meixensberger Felix Arlt
author_sort	Johannes Kasper
title	The Prognostic Value of NANO Scale Assessment in IDH-Wild-Type Glioblastoma Patients
title_short	The Prognostic Value of NANO Scale Assessment in IDH-Wild-Type Glioblastoma Patients
title_full	The Prognostic Value of NANO Scale Assessment in IDH-Wild-Type Glioblastoma Patients
title_fullStr	The Prognostic Value of NANO Scale Assessment in IDH-Wild-Type Glioblastoma Patients
title_full_unstemmed	The Prognostic Value of NANO Scale Assessment in IDH-Wild-Type Glioblastoma Patients
title_sort	prognostic value of nano scale assessment in idh-wild-type glioblastoma patients
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/94775bf4170e40539cce2cad00e99203
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The Prognostic Value of NANO Scale Assessment in IDH-Wild-Type Glioblastoma Patients

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