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Nutritional state correlates to survival and prognosis in children with brain tumor resection
Yao Chen1,2, Xin Hu3, Ting Fan2
1Department of Anesthesiology, Sanbo Brain Hospital, Capital Medical University, Beijing, People's Republic of China.
Insights
Preoperative nutritional status, tumor size, and specific biomarkers significantly impact pediatric brain tumor survival. Early nutritional assessment is crucial for better patient outcomes and management strategies.
Area of Science:
- Pediatric Neuro-oncology
- Clinical Nutrition
- Surgical Outcomes Research
Background:
- Pediatric brain tumors represent a significant oncological challenge in children.
- Understanding factors influencing survival is critical for improving patient management.
- Nutritional status is increasingly recognized as a key factor in oncological outcomes.
Purpose of the Study:
- To investigate the critical factors affecting survival in pediatric patients undergoing brain tumor resection.
- To assess the impact of nutritional status, tumor characteristics, and preoperative clinical scores on survival outcomes.
- To establish the role of preoperative nutritional assessment in predicting disease-free survival.
Main Methods:
- Retrospective analysis of 594 pediatric brain tumor cases.
- Data collection included demographics, tumor characteristics, Glasgow Coma Scale (GCS), American Society of Anesthesiologists (ASA) scores, and STRONGkids nutritional assessment.
- Survival analysis utilized Kaplan-Meier estimates and Cox proportional hazards models.
Main Results:
- High nutritional risk correlated with prolonged hospital stays and increased postoperative complications.
- For malignant tumors, medium nutritional risk was linked to better disease-free survival than high risk (P < 0.001).
- Smaller tumor size, higher GCS, and elevated preoperative albumin and prealbumin levels significantly improved survival (P < 0.001).
Conclusions:
- Preoperative nutritional status, tumor size, and specific biochemical markers (albumin, prealbumin) are vital predictors of disease-free survival in pediatric brain tumor patients.
- Comprehensive preoperative evaluations, including nutritional assessment, are essential for optimizing patient management and enhancing survival rates.
- This study underscores the importance of integrating nutritional status into clinical protocols for pediatric brain tumor care.
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.
