Table 3. Studies using the Karnofsky Performance Status.
| Study | N | Tumor type(s) | Location | Surgical approach | KPS preoperatively (/100) | KPS postoperatively (/100) | Follow-up period | Comments |
|---|---|---|---|---|---|---|---|---|
| Holmes et al15 | 79 | Multiple | Anterior, middle, and posterior cranial fossae | Not specified | 100–80 in 71% < 80 in 29% |
Not assessed | 3 mo | KPS < 80 associated with an increased risk of perioperative stroke and longer hospital stay |
| Tzortzidis et al9 | 74 | Clival and cranial base chordoma | Anterior, lateral, and posterior cranial fossae | Multiple (open) | 80 (mean) | 84 at 12 mo 86 at mean follow-up (96 mo) |
96 mo | Work subsequently extended to compare outcomes of surgery in two time periods (see Di Maio et al10) |
| Di Maio et al10 | 95 | Clival and cranial base chordoma | Anterior, lateral, and posterior cranial fossae | Multiple (open and endoscopic) | Surgery 1988–99: 81 (mean) Surgery 2000–11: 84 (mean) |
≥ 70 at 6 mo: Surgery 1988–99: 60% Surgery 2000–11: 89% |
38.3 mo | Significantly improved postoperative KPS in those undergoing surgery in the most recent cohort (2000–11) despite similar baseline KPS scores and complete resection rates |
| Bassiouni et al11 | 106 | Meningioma | Anterior clinoid process | Unilateral subfrontal or pterional | 82 | 86 | 6.9 y | |
| Ichinose et al12 | 161 | Meningioma | Anterior, middle, and posterior cranial fossae | Multiple (open) | Surgery 1985–94: 80.9 Surgery 1995–2000: 80.4 Surgery 2001–5: 86.3 |
Surgery 1985–94: 73 Surgery 1995–2000: 87.3 Surgery 2001–5: 92.3 |
95.3 mo | Three time periods classed as pre-, early, and late relative to the introduction of stereotactic radiosurgery |
| Ohba et al16 | 281 | Meningioma | Anterior, middle, and posterior cranial fossae | Not specified | 90.6 | 88.2 | 88.4 mo | In 83.3% of patients KPS score either improved (22.1%) or remained unchanged (61.2%) |
| Roser et al13 | 132 | Meningioma | Anterior, middle, and posterior cranial fossae | Not specified | ≥ 70 y of age: 82 < 70 y of age: 84 |
≥ 70 y of age: 78 < 70 y of age: 82 |
≥ 70 y of age: 36 mo < 70 y of age: 60.2 mo |
In all subjects, the minimum follow-up was 12 mo from the time of surgery |
| Raso and Gusmão8 | 22 | Multiple | Anterior, middle, and posterior cranial fossae | Transbasal approach | 79.5 | 96.4 at 12 mo | 30.5 mo | |
| Walch et al19 | 3 | Olfactory neuroblastoma | Anterior cranial fossa | ESBS combined with SRS | 100 | 39–71 mo | Time point when KPS assessed not specified. Not assessed impact of surgery alone on QoL | |
| Bassiouni et al21 | 56 | Meningioma | Olfactory groove | Multiple (open) | Not specified | 90–100 in 86.8% of survivors | 5.6 y | |
| Samii et al18 | 25 | Chondrosarcoma | Middle and posterior cranial fossae | Multiple (open) | Not specified | 91 | 88 mo | Approximately a third of patients (n = 8) underwent radiotherapy |
| Fliss et al20 | 40 | Multiple | Anterior cranial fossa | Subcranial (open) | 80 | 33 mo | Time point when KPS assessed not specified | |
| De Jesús et al17 | 118 | Meningioma | Cavernous sinus | Not specified | 90 | 80 (3–12 mo postoperative) 80 (> 1 y postoperative) |
33.8 mo | |
Abbreviations: ESBS, endoscopic skull base surgery; KPS, Karnofsky Performance Status; QoL, quality-of-life; SRS, stereotactic radiosurgery.