Nutritional state correlates to survival and prognosis in children with brain tumor resection.

Abstract

Pediatric brain tumors are the leading solid tumors in children. This study examines the critical factors influencing survival outcomes in pediatric patients undergoing brain tumor resection. We retrospectively analyzed 594 pediatric cases, collecting data on demographics, tumor characteristics, preoperative Glasgow Coma Scale (GCS), and American Society of Anesthesiologists (ASA) scores. Nutritional status was assessed using the STRONGkids tool. Survival analysis involved Kaplan-Meier estimates and Cox proportional hazards models. In regard to short-term prognosis, high nutritional risk was linked to prolonged hospital and ICU stays and more postoperative complications for all the cases. Considering the disease-free survival for malignant brain tumor cases, medium nutritional risk was associated with better survival compared with high nutritional risk (P < 0.001). Smaller tumor sizes and higher preoperative GCS scores correlated with improved survival rates (P = 0.005 and P < 0.001, respectively). Higher levels of preoperative albumin and prealbumin significantly increased survival (P < 0.001). ROC curve analysis identified optimal cutoffs for albumin (40.34 g/L) and prealbumin (192.1 mg/L) with corresponding sensitivities of 60.02% and 62.24%, and specificities of 85.06% and 73.28%, respectively. Larger tumor size, poor preoperative nutritional and neurological status, and suboptimal preoperative biochemical markers were significant predictors of increased mortality or recurrence risk. Preoperative nutritional assessment is crucial in pediatric brain tumor patients. Nutritional status, tumor size, and specific preoperative biochemical markers are vital for predicting disease-free survival outcomes. These findings highlight the need for integrating comprehensive preoperative evaluations into clinical protocols to enhance patient management and survival rates.NEW & NOTEWORTHY This is the first large-scale study to analyze the relationship between nutritional status and both short-term and relatively long-term outcomes in pediatric brain tumor patients.