P09.14 The National Institute of Health stroke scale (NIH-SS) does not predict RANO-MRI findings in the follow up assessment of glioma patients: a monocentric, retrospective analysis

Abstract

Abstract: Treatment evaluation of gliomas is performed by using the RANO criteria. They are based on cerebral MRI, steroid use, and neurological function. However, assessment of neurological function is neither defined nor standardized due to the lack of a validated measure. We used the NIH-SS to measure neurological function at baseline and follow-up in glioma patients in a standardized manner and compared the results with outcomes on MRI using the RANO criteria. Methods: Retrospective analysis of glioma patients (WHO grade II-IV; > 18 years) treated from 2008 to 2015 at the cantonal hospital St. Gallen with at least one follow up MRI including an NIH-SS assessment (0-42 points). Patients were identified by chart review. Results: We identified 61 patients (36 males, median age 52 years) with WHO grade II (10), grade III (21) and grade IV (30) gliomas who met the minimal inclusion criteria. During the observation period 45 (74%) patients progressed and 27 (44%) died. Median PFS and OS was 1.70 and 3.22 years, respectively. We evaluated 471 baseline and follow up assessments, with a median of 6 per patient (range, 2-22).Median baseline NIH-SS was 0 points (range, 0 to 7) and median change in NIH-SS was also 0 points (range,-4 to 9). Statistical analysis (Cohen’s kappa, Stuart-Maxwell-test) did not reveal an agreement of changes in NIH-SS and MRI-RANO criteria. Conclusion: Neurological follow up assessment using the NIH-SS was not a useful predictor of MRI findings in this retrospective cohort of glioma patients.