Correlation Between Preoperative Tumor Volume and Postoperative Neurological Deficit in Brain Tumor Resections

Abstract

Objective:  To evaluate the correlation between preoperative tumor volume and the development of early postoperative neurological deficits in patients undergoing brain tumor resections.

Materials and Methods:  A prospective observational study was conducted at Lady Reading Hospital, Peshawar, from January to December 2024. A total of 130 patients undergoing elective craniotomy for brain tumor resection were enrolled. Preoperative tumor volume was calculated using contrast-enhanced T1-weighted MRI via manual segmentation. Neurological status was assessed within 72 hours postoperatively. Data were analyzed using SPSS version 26.0, applying independent t-tests, ROC analysis, and logistic regression.

Results:  Out of 130 patients, 38 (29.2%) developed new or worsened neurological deficits postoperatively. Patients with deficits had significantly larger mean tumor volumes (61.8 ± 17.2 cm³) compared to those without deficits (42.7 ± 14.5 cm³, p < 0.001). A tumor volume cutoff of 51.5 cm³ predicted deficits with 81.6% sensitivity and 75.3% specificity (AUC = 0.83). Logistic regression confirmed tumor volume as an independent predictor (OR: 2.06; p < 0.01).

Conclusion:  Preoperative tumor volume is significantly associated with early postoperative neurological deficits. A volumetric threshold may serve as a valuable tool for surgical risk assessment and patient counseling in brain tumor surgery.