Journal of Neuro-Oncology ( IF 3.2 ) Pub Date : 2023-08-25 , DOI: 10.1007/s11060-023-04416-1
Hanya M Qureshi 1, 2, 3 , Joanna K Tabor 2, 3 , Kiley Pickens 2, 3 , Haoyi Lei 2, 3 , Sagar Vasandani 2, 3 , Muhammad I Jalal 2, 3 , Shaurey Vetsa 2, 3 , Aladine Elsamadicy 2, 3 , Neelan Marianayagam 2, 3 , Brianna C Theriault 2, 3 , Robert K Fulbright 3, 4 , Ruihan Qin 3, 4 , Jiarui Yan 3, 4 , Lan Jin 2, 3 , Joseph O'Brien 2, 3 , Saul F Morales-Valero 2, 3 , Jennifer Moliterno 2, 3
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Purpose
Frailty has gained prominence in neurosurgical oncology, with more studies exploring its relationship to postoperative outcomes in brain tumor patients. As this body of literature continues to grow, concisely reviewing recent developments in the field is necessary. Here we provide a systematic review of frailty in brain tumor patients subdivided by tumor type, incorporating both modern frailty indices and traditional Karnofsky Performance Status (KPS) metrics.
Methods
Systematic literature review was performed using PRISMA guidelines. PubMed and Google Scholar were queried for articles related to frailty, KPS, and brain tumor outcomes. Only articles describing novel associations between frailty or KPS and primary intracranial tumors were included.
Results
After exclusion criteria, systematic review yielded 52 publications. Amongst malignant lesions, 16 studies focused on glioblastoma. Amongst benign tumors, 13 focused on meningiomas, and 6 focused on vestibular schwannomas. Seventeen studies grouped all brain tumor patients together. Seven studies incorporated both frailty indices and KPS into their analyses. Studies correlated frailty with various postoperative outcomes, including complications and mortality.
Conclusion
Our review identified several patterns of overall postsurgical outcomes reporting for patients with brain tumors and frailty. To date, reviews of frailty in patients with brain tumors have been largely limited to certain frailty indices, analyzing all patients together regardless of lesion etiology. Although this technique is beneficial in providing a general overview of frailty’s use for brain tumor patients, given each tumor pathology has its own unique etiology, this combined approach potentially neglects key nuances governing frailty’s use and prognostic value.
中文翻译：
脑肿瘤患者的虚弱和术后结果：按肿瘤病因细分的系统评价
目的
虚弱在神经外科肿瘤学中越来越受到重视，越来越多的研究探索其与脑肿瘤患者术后结果的关系。随着文献数量的不断增长，有必要简要回顾该领域的最新发展。在这里，我们对脑肿瘤患者的衰弱情况进行了系统回顾，按肿瘤类型细分，结合了现代衰弱指数和传统的卡诺夫斯基表现状态（KPS）指标。
方法
使用 PRISMA 指南进行系统文献综述。查询了 PubMed 和 Google Scholar 中与虚弱、KPS 和脑肿瘤结果相关的文章。仅纳入描述虚弱或 KPS 与原发性颅内肿瘤之间新关联的文章。
结果
排除标准后，系统审查产生了 52 篇出版物。在恶性病变中，16 项研究重点关注胶质母细胞瘤。在良性肿瘤中，13 例为脑膜瘤，6 例为前庭神经鞘瘤。十七项研究将所有脑肿瘤患者分组在一起。七项研究将衰弱指数和 KPS 纳入其分析中。研究将虚弱与各种术后结果（包括并发症和死亡率）联系起来。
结论
我们的审查确定了脑肿瘤和虚弱患者总体术后结果报告的几种模式。迄今为止，对脑肿瘤患者虚弱程度的评价很大程度上仅限于某些虚弱指数，无论病变病因如何，都对所有患者进行分析。尽管该技术有利于提供衰弱对脑肿瘤患者的使用的总体概述，但鉴于每种肿瘤病理学都有其独特的病因学，这种组合方法可能忽略了控制衰弱的使用和预后价值的关键细微差别。
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