Journal of Neuro-Oncology最新文献

{"title":"Postoperative hydrocephalus in patients with infratentorial brain metastases may be influenced by preoperative treatment: a single-center cohort study.","authors":"Luisa Mona Kraus, Maria Goldberg, Eugen Ursu, Kayra Demirbag, Simon Paul Backhaus, Ghaith Altawalbeh, Denise Bernhardt, Chiara Negwer, Stephanie Combs, Bernhard Meyer, Arthur Wagner","doi":"10.1007/s11060-025-05125-7","DOIUrl":"https://doi.org/10.1007/s11060-025-05125-7","url":null,"abstract":"<p><strong>Purpose: </strong>Infratentorial brain metastases (BM), particularly those causing obstruction of the fourth ventricle, are associated with a significant risk of postoperative hydrocephalus. This complication remains poorly understood, especially regarding its predictors beyond mechanical obstruction. This study aims to identify clinical predictors of postoperative hydrocephalus in patients undergoing surgery for infratentorial BM.</p><p><strong>Methods: </strong>We performed a single-center retrospective analysis of 235 adult patients surgically treated for infratentorial BM between 2009 and 2025. Patients with leptomeningeal disease were excluded. Pre- and postoperative hydrocephalus were defined based on imaging and clinical criteria. Logistic regression and multivariate modeling were used to evaluate predictors, including clinical presentation, treatment history, and imaging features.</p><p><strong>Results: </strong>Postoperative hydrocephalus occurred in 18.45% of patients. Breast cancer patients exhibited the highest incidence (30.61%), significantly more than those with lung cancer (15.66%, p = 0.042). Preoperative hydrocephalus (p = 0.005), and prior chemotherapy (p = 0.001) or radiotherapy (p = 0.004) were significantly associated with postoperative hydrocephalus. Imaging variables, including tumor volume or proximity to the fourth ventricle, were not predictive. Multivariate regression confirmed preoperative hydrocephalus, and systemic treatment as independent risk factors.</p><p><strong>Conclusion: </strong>Postoperative hydrocephalus in infratentorial BM is influenced not only by mechanical factors but also by preoperative clinical and therapeutic variables. Breast cancer patients, particularly those who received prior systemic or local therapy, are at higher risk. These findings suggest the need for individualized risk assessment and raise the question of whether prophylactic interventions could mitigate complications and treatment delays in high-risk cohorts.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shared decision-making interventions in neuro-oncology practice: a systematic review.","authors":"Jasmine G Hughes, Francesca M Cozzi, Veronica Phillips, Stephen J Price","doi":"10.1007/s11060-025-05141-7","DOIUrl":"https://doi.org/10.1007/s11060-025-05141-7","url":null,"abstract":"<p><strong>Background: </strong>Shared decision-making (SDM) has been shown to be beneficial to patients and improve health outcomes. While more research is being conducted on the topic of SDM, the incorporation of interventions to facilitate or improve SDM in neuro-oncology has not been widely studied. This study aimed to systematically review the types and impact of SDM interventions used in neuro-oncology.</p><p><strong>Methods: </strong>Systematic searches were conducted in Medline, Embase, Global Health, Cinahl, Web of Science, and Scopus from inception to May 2024. Full-text, peer-reviewed articles were evaluated based on inclusion criteria. Data extracted from articles included the author, year, location, type of intervention, and variable outcomes.</p><p><strong>Results: </strong>The searches resulted in 4674 original articles. Four studies with a total of 172 patients diagnosed with anaplastic oligodendroglioma, anaplastic astrocytoma, high-grade glioma (HGG), low-grade glioma (LGG), glioblastoma, and brain metastases met the inclusion criteria. Types of SDM interventions included SDM training for health care workers, decision grids, three-dimensional (3D) printed models of brain tumors, goals of care videos, and an online tool providing information on disease progression. Overall impact of SDM interventions resulted in improvement in patients' understanding of their medical condition, treatment options, and satisfaction with the SDM process.</p><p><strong>Conclusion: </strong>SDM can be improved through the use of interventions and aids and can have a positive impact on brain tumor patients. However, there is a significant gap within neuro-oncology literature on SDM interventions. Therefore, to understand how to best improve SDM from the perspective of patients, there is a pressing need for more research on SDM interventions in neuro-oncology.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Independent histological validation of MR-derived radio-pathomic maps of tumor cell density using image-guided biopsies in human brain tumors.","authors":"Gianluca Nocera, Francesco Sanvito, Jingwen Yao, Sonoko Oshima, Samuel A Bobholz, Ashley Teraishi, Catalina Raymond, Kunal Patel, Richard G Everson, Linda M Liau, Jennifer Connelly, Antonella Castellano, Pietro Mortini, Noriko Salamon, Timothy F Cloughesy, Peter S LaViolette, Benjamin M Ellingson","doi":"10.1007/s11060-025-05105-x","DOIUrl":"10.1007/s11060-025-05105-x","url":null,"abstract":"<p><strong>Purpose: </strong>In brain gliomas, non-invasive biomarkers reflecting tumor cellularity would be useful to guide supramarginal resections and to plan stereotactic biopsies. We aim to validate a previously-trained machine learning algorithm that generates cellularity prediction maps (CPM) from multiparametric MRI data to an independent, retrospective external cohort of gliomas undergoing image-guided biopsies, and to compare the performance of CPM and diffusion MRI apparent diffusion coefficient (ADC) in predicting cellularity.</p><p><strong>Methods: </strong>A cohort of patients with treatment-naïve or recurrent gliomas were prospectively studied. All patients underwent pre-surgical MRI according to the standardized brain tumor imaging protocol. The surgical sampling site was planned based on image-guided biopsy targets and tissue was stained with hematoxylin-eosin for cell density count. The correlation between MRI-derived CPM values and histological cellularity, and between ADC and histological cellularity, was evaluated both assuming independent observations and accounting for non-independent observations.</p><p><strong>Results: </strong>Sixty-six samples from twenty-seven patients were collected. Thirteen patients had treatment-naïve tumors and fourteen had recurrent lesions. CPM value accurately predicted histological cellularity in treatment-naïve patients (b = 1.4, R² = 0.2, p = 0.009, rho = 0.41, p = 0.016, RMSE = 1503 cell/mm²), but not in the recurrent sub-cohort. Similarly, ADC values showed a significant association with histological cellularity only in treatment-naive patients (b = 1.3, R² = 0.22, p = 0.007; rho = -0.37, p = 0.03), not statistically different from the CPM correlation. These findings were confirmed with statistical tests accounting for non-independent observations.</p><p><strong>Conclusion: </strong>MRI-derived machine learning generated cellularity prediction maps (CPM) enabled a non-invasive evaluation of tumor cellularity in treatment-naïve glioma patients, although CPM did not clearly outperform ADC alone in this cohort.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of clinical and volumetric outcomes following adaptive gamma knife radiosurgery for brain metastases.","authors":"Venkatesh S Madhugiri, Victor Goulenko, Lokesh Seth, Richard Wang, Sarunas Tamasauskas, Neil D Almeida, Andrew J Fabiano, Lindsay J Lipinski, Kenneth V Snyder, Robert J Plunkett, Robert A Fenstermaker, Matthew B Podgorsak, Dheerendra Prasad","doi":"10.1007/s11060-025-05138-2","DOIUrl":"10.1007/s11060-025-05138-2","url":null,"abstract":"<p><strong>Background: </strong>Hypofractionated stereotactic radiosurgery is an effective technique to treat larger brain metastases and post-surgical cavities. Adaptive Gamma Knife radiosurgery (aGKRS), involving repeat magnetic resonance imaging (MRI) and replanning based on modified lesion contours, has emerged as a solution to account for inter-fraction tumor dynamics.</p><p><strong>Objective: </strong>To evaluate the impact of adaptive planning on treatment metrics, radiation dose to structures at risk (SARs), and clinical and radiologic outcomes in patients with brain metastases.</p><p><strong>Methods: </strong>Over an 8-year period (2016-2023), 31 patients were treated with aGKRS to 48 brain metastases. Lesions were re-contoured and adaptive plans created using updated MRIs acquired prior to the second radiation fraction. Treatment metrics, including target coverage, Paddick Conformity Index (PCI), Gradient Index (GI), and doses to SARs, were analyzed. Clinical outcomes and radiologic response were assessed.</p><p><strong>Results: </strong>Lesion volumes changed significantly between radiation fractions (mean change- 28.25%). aGKRS resulted in significant improvements in target coverage, from 91.9% on non-adaptive plans to 97.02% following adaptive replanning. The PCI improved by 35.3% across plans in this series. Adaptive plans also reduced the dose to SARs by an average of 4.7%. Radiologic response was excellent- median volume reduction of treated lesions was 98.9%. Clinically, 72% of patients either remained stable or improved in neurologic status; 32% improved in performance status by at least one grade.</p><p><strong>Conclusion: </strong>Lesion dynamics during hypofractionated treatments pose a significant challenge to the delivery of conformal and safe SRS treatments. aGKRS significantly improves dosimetric parameters, reduces radiation to SARs, and enhances clinical and radiologic outcomes for brain metastases.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of skull base meningiomas with extracranial extension: resection, recurrence, and prognostic factors.","authors":"Juan P Zuluaga-Garcia, Esteban Ramirez-Ferrer, Sophie F Peeters, Franco DeMonte, Shaan M Raza","doi":"10.1007/s11060-025-05111-z","DOIUrl":"https://doi.org/10.1007/s11060-025-05111-z","url":null,"abstract":"<p><strong>Purpose: </strong>To assess clinical, radiographic, surgical, and pathological factors affecting outcomes in patients with skull-base meningiomas (SBMs) with extracranial extension, focusing on extent of resection (EOR), recurrence rates, postoperative complications, and skull-base (SB) reconstruction strategies.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 101 patients with SBMs and transcranial extension treated surgically between 1993 and 2024. Tumors were categorized by the Irish classification (Zones I-III). We collected demographics, imaging, surgical details (approach and EOR), pathology (WHO grade, brain invasion, cranial-nerve involvement), and adjuvant therapy. Primary outcomes included gross total resection (GTR) rate, postoperative complications, progression-free survival (PFS), and overall survival (OS). Multivariable Cox-regression and Firth's-logistic regression identified independent predictors.</p><p><strong>Results: </strong>Zone I was most common (47%), with orbital (41%) and infratemporal-fossa (18%) extension. GTR was achieved in 61.4% overall-highest in Zone I (70.2%). Cerebrospinal-fluid leaks occurred in 8% (highest in Zone III, 27%), and wound infections in 2.9%, none requiring debridement. Tumor recurrence occurred in 40%; subtotal resection (STR; hazard ratio [HR] 2.73, p = 0.014), WHO grade III (HR 27.3, p = 0.003), cranial-nerve dysfunction, and brain invasion independently predicted reduced PFS. STR, Simpson grade > 1, cavernous-sinus invasion, and brain invasion predicted worse OS. Multidisciplinary SB reconstruction using autologous grafts and prosthetic materials (PEEK, titanium mesh) was essential to minimize morbidity.</p><p><strong>Conclusion: </strong>SBMs with extracranial extension present complex surgical challenges. EOR, tumor histology, and invasion of critical structures significantly influence recurrence and survival. Tailored surgical planning by zone and comprehensive SB reconstruction are critical to optimize outcomes and reduce postoperative morbidity.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term clinical outcomes of bevacizumab for treatment of stereotactic radiosurgery-induced radiation necrosis in patients with brain metastases.","authors":"Kylie Jung, Sudhir Das Sivadas, Xavier Fitzgerald, Claire Phillips, Nikki Plumridge, Lavinia Spain, Aparna D Rao, Joseph Sia","doi":"10.1007/s11060-025-05121-x","DOIUrl":"https://doi.org/10.1007/s11060-025-05121-x","url":null,"abstract":"<p><strong>Purpose: </strong>Radiation necrosis (RN) is a potentially debilitating complication of stereotactic radiosurgery (SRS) for brain metastases (BrM). Bevacizumab, a monoclonal antibody against vascular endothelial growth factor A, is increasingly used for treating symptomatic RN. This multi-institutional retrospective study examines its longitudinal efficacy, toxicity, and steroid-sparing effect in BrM patients with SRS-induced RN over an extended follow-up.</p><p><strong>Methods: </strong>BrM patients from two Australian health networks who received bevacizumab between 2018 and 2023 for SRS-induced RN were identified. Patient characteristics, symptomatic and radiological responses, steroid use, and toxicities were recorded. Time-to-events and associations with outcomes were analysed with Kaplan-Meier and Cox methods.</p><p><strong>Results: </strong>26 patients were analysed over a median follow-up of 21.2 months. The most common bevacizumab schedule was 7.5 mg/kg 3-weekly for a median of 3 cycles. Symptomatic responses were detectable 1-week post-commencement, improving headache and neurological deficits in 60% and 80% of patients by 6 months. 88% had radiological improvement by a median of 7 weeks. 71% of those on steroids could cease steroids over a median of 1.9 month. 19% developed recurrent, symptomatic RN 9.5-28.5 months after bevacizumab cessation. 75% of those re-treated with bevacizumab for recurrent RN gained further symptomatic improvement. Grade 2 + toxicity rate was 24% (venous thromboembolism: 12%; hypertension: 8%; intra-tumoural haemorrhage: 4%).</p><p><strong>Conclusion: </strong>Bevacizumab is an effective treatment for symptomatic, steroid-dependent SRS-induced RN but is associated with moderate rates of Grade 2-3 toxicities and recurrent, symptomatic RN after its cessation. Bevacizumab rechallenge remains useful for recurrent RN. Multi-disciplinary input and careful surveillance remain critical for its use in BrM patients.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of life in pediatric patients treated with adjuvant proton radiation for craniopharyngiomas.","authors":"Melanie L Rose, Benjamin V M Bajaj, Rachel Jimenez, Sara Dennehy, Keith Allison, Laura Wiltsie, David Ebb, Shannon M MacDonald, Nancy J Tarbell, Torunn I Yock","doi":"10.1007/s11060-025-05112-y","DOIUrl":"https://doi.org/10.1007/s11060-025-05112-y","url":null,"abstract":"<p><strong>Background: </strong>Pediatric craniopharyngiomas are curable tumors. Significant morbidity is reported from the tumor itself as well as treatments (surgery and radiotherapy (RT)), which adversely affects health-related quality of life (HRQoL) outcomes, which we reported and correlated with other health outcomes.</p><p><strong>Methods: </strong>HRQoL data was collected from a prospective cohort of proton treated patients with craniopharyngiomas (≤ 22 years at the time of RT). Parents and children were surveyed using the Pediatric Quality of Life Inventory (PedsQL) collected at baseline and annually thereafter. We compared last follow-up parent-proxy reports (PPR) and Child-self reports (CSR) in patients with and without treatment sequelae. We compared last follow-up PPR total core scores (TCS) to values representative of a normal population.</p><p><strong>Results: </strong>47 participants were included and median follow-up was 11.2 years. Median age at RT was 9.7 years. PPR and CSR TCS at last follow-up, 70.8 and 75.5 respectively, were significantly lower than normal controls (p < 0.01). At last follow up, PPR TCS was lower in patients with arginine vasopressin deficiency (AVP-D) (65.6 vs. 79.0, p = 0.01), sex hormone deficiency (67.6 vs. 78.85 p = 0.03), and hyperphagia (64.1 vs. 79.4, p < 0.01). Patients who were treated with RT at time of recurrence had 1.40 × (95% CI, 1.08-1.81, p = 0.011) the rate of sequala development compared to those treated at initial diagnosis.</p><p><strong>Conclusions: </strong>HRQoL TCSs were significantly worse than healthy controls. Hyperphagia, AVP-D and sex hormone deficiencies, correlated with worse PPR TCS. Those treated with RT at time of recurrence had higher sequalae burden than those treated at initial diagnosis.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The communication of a high-grade glioma diagnosis- patients' reflections and perspectives based on a study-specific questionnaire.","authors":"Denise Loeschner, Prajjwal Raj Wagle, Anna Jung, Anne Neumeister, Anna Cecilia Lawson McLean, Ruediger Gerlach","doi":"10.1007/s11060-025-05129-3","DOIUrl":"https://doi.org/10.1007/s11060-025-05129-3","url":null,"abstract":"<p><strong>Purpose: </strong>To analyze the communication setting of a high-grade glioma (HGG) diagnosis, patients' emotional responses and their needs of further support and information as well as education about the disease to optimize neuro-oncological treatment.</p><p><strong>Methods: </strong>In a single-center survey, a 10-item questionnaire was developed to analyse the setting of communication, emotional aspects, needs and impression of education or information in patients with HGG between March and May of 2024. Three questions focused on the conversation setting, two on education, one on emotional aspects, and four on patients' support. Descriptive statistics and Chi Square tests were used to analyze these multidimensional items.</p><p><strong>Results: </strong>Patients' age ranged from 27 to 77 years (median 55), 14 patients (28%) were female, and 36 (72%) were male. Most patients (62%, 31/50) received support when informed of their diagnosis, primarily from relatives (42%, 21/50), especially life partners (22%, 11/50). A majority (64%, 32/50) were satisfied with the initial information received, while 32% (16/50) preferred additional details. Less than half of the patients (21/50, 42%) used further possibilities for support. Patients indicated their need of further information in 14% (7/50), additional support in 12% (6/50, 12%) and extended conversation time in 10%.</p><p><strong>Conclusion: </strong>Each patient should receive individualized medical consultations to adequately communicate the HGG diagnosis and treatment requirements. Discussions about treatment options and recommendations should involve patients' support systems, including family members or close friends. Despite the availability of psycho-oncological support during hospitalization, ongoing community support for patients and caregivers is essential and should be promoted early. Continuous improvements in patient education, accessibility, and caregiver support will enhance coping, resilience and caregivers' mastery in neuro-oncology.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient nutritional status is associated with surgical site infections in meningioma patients undergoing craniotomy for tumor resection.","authors":"Sachiv Chakravarti, Linda Tang, Harshal A Shah, Arjit Singh, Yuncong Mao, Jacob Gould, Emre Derin, Ritvik Pulya, Esther Wu, Raj Patel, Sreyas Kanaparti, Adrian E Jimenez, A Karim Ahmed, Christopher Jackson, Chetan Bettegowda, Gary Gallia, Jon Weingart, Debraj Mukherjee","doi":"10.1007/s11060-025-05123-9","DOIUrl":"https://doi.org/10.1007/s11060-025-05123-9","url":null,"abstract":"<p><strong>Introduction: </strong>Surgical site infections (SSIs) represent a significant burden to patients and healthcare systems. We sought to identify risk factors associated with post-operative SSIs for patients undergoing surgery for the resection of an intracranial meningioma.</p><p><strong>Methods: </strong>The authors retrospectively reviewed records of meningioma patients who had undergone surgical resection at a single institution between January 2005 and December 2020. Demographics, clinical characteristics, and preoperative nutrition indices were collected through manual chart review. Scalp incisions were categorized as linear/curvilinear, reverse question mark, trapdoor or frontotemporal. The Mann-Whitney U and Fisher exact tests were used for bivariate analyses of continuous variables and categorical variables respectively. Multivariate logistic regression was used to assess factors associated with SSI.</p><p><strong>Results: </strong>A total of 304 meningioma cases were identified, 15 (4.9%) of which were diagnosed with a postoperative SSI. Patients in the SSI group were significantly more likely to have a non-skull base meningioma (80% vs. 46.4%, p = 0.01), gross total resection (GTR) of tumor (93.3% vs. 67.8%, p = 0.04), and previous diagnosis of diabetes mellitus (DM) (40% vs. 15.2%, p = 0.02). Patients in the SSI group also had a significantly higher average Charlson comorbidity index (CCI) (2.8 ± 2.3 vs. 1.7 ± 2.2, p = 0.03) and a significantly lower nutritional risk index (NRI) (97.8 ± 4.9 vs. 103.9 ± 7.8, p < 0.01). On multivariate analysis, decreasing NRI score (OR 0.91, 95% CI 0.84-0.98, p = 0.02) is independently associated with development of an SSI.</p><p><strong>Conclusions: </strong>Results from this study indicate that preoperative nutritional status is a significant risk factor for SSI development in meningioma patients. These findings may be used to drive risk stratification efforts for this vulnerable patient population.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of prolonged length of stay in patients undergoing laser interstitial thermal therapy for intracranial tumors.","authors":"Khushi H Shah, Adham M Khalafallah, Maxon V Knott, Chandler N Berke, Christian K Ramsoomair, Victor M Lu, Michael E Ivan, Ricardo J Komotar, Ashish H Shah","doi":"10.1007/s11060-025-05101-1","DOIUrl":"https://doi.org/10.1007/s11060-025-05101-1","url":null,"abstract":"<p><strong>Purpose: </strong>Laser interstitial thermal therapy (LITT) offers a minimally invasive approach for treating intracranial pathologies while offering shorter length of stays (LOS) as compared to traditional craniotomies. Yet, some patients still face prolonged LOS (pLOS), highlighting the need to identify factors contributing to pLOS to improve outcomes.</p><p><strong>Methods: </strong>We retrospectively reviewed patients who underwent LITT for intracranial pathologies at our institution from 2012 to 2023. Patients with LOS ≥ 75th percentile formed the study group, while those with LOS < 75th percentile formed control group. Patient demographics and perioperative factors were analyzed. Bivariate statistical analyses included Fisher's exact test, chi-square test, and t-tests. Univariate and multivariate logistic regression identified significant predictors of pLOS.</p><p><strong>Results: </strong>Of 294 patients in this study, 73 patients in the study group (mean age 62.14 ± 11.63 years, 54.8% males) with a median LOS of 4.12 [IQR: 3.01-6.67] days were compared to 221 controls (mean age 59.50 ± 14.01 years, 40.3% males) with a median LOS of 1.92 [IQR: 1.86-2.01] days. Upon multivariate analysis, higher mFI-5 scores (OR 1.80; 95% CI [1.31-2.47]; p < 0.001), preoperative neurologic deficits (OR 2.27; 95% CI [1.09-4.76]; p = 0.029), and preoperative tumor volume (OR 2.03; 95% CI [1.46-2.83]; p < 0.001) were significantly associated with pLOS. Operative time, number of pullbacks, and extent of ablation were not significantly associated with pLOS (p > 0.05).</p><p><strong>Conclusion: </strong>To our knowledge, this is the first study to identify preoperative mFI-5 score, neurological deficit, and tumor volume as independent predictors of pLOS in patients undergoing LITT for intracranial pathologies.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}