Abstract

Abstract BACKGROUND Age, molecular features, extent of resection, and adjuvant treatment are well established prognostic factors for patients with glioblastoma. Neurological Assessment in Neuro-Oncology (NANO) Scale was designed as a tool to provide an objective clinician-reported outcome of neurologic and complements the radiological evaluation of the Response Assessment in Neuro-Oncology (RANO) criteria. Despite the generally detrimental prognosis associated with severe new neurological deficits after surgery, a comprehensive understanding of the impact of pre- and postoperative neurological status remains limited. This study explores the potential of the NANO scale to predict survival when applied immediately before and after surgery. METHODS This retrospective study examined adult patients in South-Eastern Norway who underwent resection for IDH wildtype glioblastoma between January 2020 and December 2021. We used Kaplan Meier curve calculate median overall survival and chi-square and log rank test were used to compare groups. RESULTS The study included 187 patients, with a median overall survival was 14.9 months. Patients with a preoperative NANO-score of 0-2 had a median survival of 17.4 months, compared to 11.3 months for patients scoring 3 or more points (p< 0.001). Neither Postoperative NANO scores nor changes in NANO scores in pre- to postoperative score were found to be significant predictors for survival. CONCLUSIONS This study indicates that a low preoperative NANO were predictive for a longer median survival, whereas postoperative NANO scores didn’t show the same impact. Surprisingly, an increase in the postoperative NANO score, indicating new, or worsening of the neurological deficits, didn′t correlate with a shorter median survival.

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