Peritumoural oedema volume as a predictor of neurological and functional outcomes in patients with gliomas

The purpose of the study was to evaluate the prognostic significance of the preoperative volume of peritumoural oedema according to magnetic resonance imaging in patients with gliomas. A single-centre observational study was conducted, including 60 patients aged 21 to 75 years, with predominance of high-grade diffuse gliomas grade 4 according to the World Health Organisation classification. The volume of peritumoural oedema was determined using magnetic resonance imaging in T2-weighted and fluid-attenuated inversion recovery (FLAIR) sequences by means of volumetric analysis, followed by stratification into four groups. Neurological, cognitive, and functional status were assessed using the National Institutes of Health Stroke Scale, the Mini-Mental State Examination, and the modified Rankin Scale, with final evaluation performed at 6 months. It was found that the preoperative peritumoural oedema volume significantly correlated with the severity of functional deficiency 6 months after surgery (correlation coefficient r = 0.68; p < 0.001; 95% confidence interval 0.52-0.81). It was shown that with a peritumoural oedema volume of 30 cm3 or more, the proportion of adverse outcomes on the modified Rankin Scale of more than 2 points was 60.0%, whereas with a peritumoural oedema volume of less than 30 cm³, this indicator did not exceed 26.7%. It was calculated that the presence of peritumoural oedema with a volume of 30 cm³ or more is associated with a 4.13-fold increase in the probability of an unfavourable functional outcome (odds ratio 4.13; 95% confidence interval 1.39-12.27; p < 0.01). It was found that after surgical resection, the average volume of peritumoural oedema decreased dynamically, but on the first day there was a temporary increase in oedema followed by regression by days 14-30. A provision has been developed that the quantitative assessment of peritumoural oedema according to preoperative magnetic resonance imaging can be used as an objective criterion for risk stratification and planning decongestant therapy in patients with gliomas