Vascular encasement score as a prognostic tool for outcome in skull base tumor resection
Objective - Involvement of major cerebral arteries in skull-base tumors poses a significant surgical challenge and is associated with increased peri- and postoperative complication rates. The aim of the current study is to introduce a vascular encasement score (VES) to assess intraoperative risk and...
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| Hauptverfasser: | , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
[13 August 2025]
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| In: |
World neurosurgery
Year: 2025, Jahrgang: 202, Pages: 1-9 |
| ISSN: | 1878-8769 |
| DOI: | 10.1016/j.wneu.2025.124375 |
| Online-Zugang: | Verlag, kostenfrei, Volltext: https://doi.org/10.1016/j.wneu.2025.124375 Verlag, kostenfrei, Volltext: https://www.sciencedirect.com/science/article/pii/S1878875025007314 
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| Verfasserangaben: | Iryna Bulakh, Robert Lucaciu, Nikola Duerr, Martin Scholz, Bogdana Suchorska |
| Zusammenfassung: | Objective - Involvement of major cerebral arteries in skull-base tumors poses a significant surgical challenge and is associated with increased peri- and postoperative complication rates. The aim of the current study is to introduce a vascular encasement score (VES) to assess intraoperative risk and predict patient outcomes. - Methods - Patients undergoing surgery for skull base tumors involving at least one major cerebral artery between April 2019 and March 2022 were included. Tumor-vessel contact was assessed on preoperative magnetic resonance imaging, evaluating both the longitudinal and circumferential encasement of arteries. Each parameter was graded from 1 to 5. The VES was calculated by multiplying the summed grades of both dimensions. Neurological outcomes were dichotomized into “good” and “poor” and correlated with VES. - Results - Forty-eight patients were enrolled, most diagnosed with meningioma (79.17%). The mean resection rate was 77.23%, and the median VES was 32.5. Sixteen patients (33.3%) had poor outcomes. Higher VES scores were significantly associated with poor outcomes (P = 0.019). A receiver operating characteristic-derived threshold of 75 defined high-risk cases. Logistic regression confirmed that high VES (>75) predicted worse outcomes (P = 0.018). All patients with low VES had favorable outcomes and resection rates >90%. In contrast, 62.5% of patients with high VES had poor outcomes, influenced by a lower extent of resection (P < 0.001). - Conclusions - The magnetic resonance imaging-based VES provides a practical method to quantify vascular involvement in skull base tumors. It may support risk-adapted surgical planning and serve as a foundation for Artificial Intelligence-based tools enabling automated preoperative risk assessment. |
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| Beschreibung: | Gesehen am 28.01.2026 |
| Beschreibung: | Online Resource |
| ISSN: | 1878-8769 |
| DOI: | 10.1016/j.wneu.2025.124375 |