Patient selection: surgery for a brain tumor
Outcome: change between preoperative and postoperative Karnofsky Performance Status
Parameters (the "Big Five"):
(1) major brain vessel manipulation
(2) tumor in the posterior fossa
(3) manipulation of a cranial nerve
(4) tumor involving an eloquent area (motor, sensory, language, visual area, hypothalamus, thalamus, internal capsule, brainstem, pineal region)
(5) tumor diameter in cm
|
Parameter
|
Finding
|
Points
|
|
major brain vessel manipulation
|
no
|
0
|
|
|
yes
|
1
|
|
tumor in the posterior fossa
|
no
|
0
|
|
|
yes
|
1
|
|
manipulation of a cranial nerve
|
no
|
0
|
|
|
yes
|
2
|
|
tumor involving an eloquent area
|
no
|
0
|
|
|
yes
|
3
|
|
tumor diameter
|
<= 4 cm
|
0
|
|
|
> 4 cm
|
1
|
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 8
• A score <= 2 is not associated with clinical worsening.
• A score >= 3 is associated with clinical worsening.
