Toward a systematic grading for the selection of patients to undergo awake surgery

• Verfasst von: Kram, Leonie [VerfasserIn]
• Verfasst von: Neu, Beate [VerfasserIn]
• Verfasst von: Schroeder, Axel [VerfasserIn]
• Verfasst von: Wiestler, Benedikt [VerfasserIn]
• Verfasst von: Meyer, Bernhard [VerfasserIn]
• Verfasst von: Krieg, Sandro [VerfasserIn]
• Verfasst von: Ille, Sebastian [VerfasserIn]
• Titel: Toward a systematic grading for the selection of patients to undergo awake surgery
• Titelzusatz: identifying suitable predictor variables
• Verf.angabe: Leonie Kram, Beate Neu, Axel Schroeder, Benedikt Wiestler, Bernhard Meyer, Sandro M. Krieg and Sebastian Ille
• E-Jahr: 2024
• Jahr: 02 May 2024
• Umfang: 11 S.
• Illustrationen: Illustrationen
• Fussnoten: Gesehen am 09.11.2024
• Titel Quelle: Enthalten in: Frontiers in human neuroscience
• Ort Quelle: Lausanne : Frontiers Research Foundation, 2008
• Jahr Quelle: 2024
• Band/Heft Quelle: 18(2024) vom: 2. Mai, Artikel-ID 1365215, Seite 1-11
• ISSN Quelle: 1662-5161
• DOI: doi:10.3389/fnhum.2024.1365215
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Awake craniotomy
• Sach-SW: Glioma
• Sach-SW: language eloquence
• Sach-SW: Multinomial Logistic Regression
• Sach-SW: preoperative language status
• K10plus-PPN: 1908108991
• K10plus-PPN:
  Universitätsbibliothek
• Lokale URL UB: Zum Volltext

Abstract

<sec id="sec1"><title>Background</title><p>Awake craniotomy is the standard of care for treating language eloquent gliomas. However, depending on preoperative functionality, it is not feasible in each patient and selection criteria are highly heterogeneous. Thus, this study aimed to identify broadly applicable predictor variables allowing for a more systematic and objective patient selection.</p></sec><sec id="sec2"><title>Methods</title><p>We performed post-hoc analyses of preoperative language status, patient and tumor characteristics including language eloquence of 96 glioma patients treated in a single neurosurgical center between 05/2018 and 01/2021. Multinomial logistic regression and stepwise variable selection were applied to identify significant predictors of awake surgery feasibility.</p></sec><sec id="sec3"><title>Results</title><p>Stepwise backward selection confirmed that a higher number of paraphasias, lower age, and high language eloquence level were suitable indicators for an awake surgery in our cohort. Subsequent descriptive and ROC-analyses indicated a cut-off at ≤54 years and a language eloquence level of at least 6 for awake surgeries, which require further validation. A high language eloquence, lower age, preexisting semantic and phonological aphasic symptoms have shown to be suitable predictors.</p></sec><sec id="sec4"><title>Conclusion</title><p>The combination of these factors may act as a basis for a systematic and standardized grading of patients’ suitability for an awake craniotomy which is easily integrable into the preoperative workflow across neurosurgical centers.</p></sec>