• Timothy H Ung, Douglas E Ney, Denise Damek, Chad G Rusthoven, A Samy Youssef, Kevin O Lillehei, and D Ryan Ormond.
• Department of Neurosurgery, University of Colorado School of Medicine, Aurora, Colorado.
• Neurosurgery. 2019 Mar 1; 84 (3): 687-695.

BackgroundThe Neurologic Assessment in Neuro-Oncology (NANO) scale is a standardized objective metric designed to measure neurological function in neuro-oncology. Current neuroradiological evaluation guidelines fail to use specific clinical criteria for progression.ObjectiveTo determine if the NANO scale was a reliable assessment tool in glioblastoma (GBM) patients and whether it correlated to survival.MethodsOur group performed a retrospective review of all patients with newly diagnosed GBM from January 1, 2010, through December 31, 2012, at our institution. We applied the NANO scale, Karnofsky performance score (KPS), Eastern Cooperative Oncology Group (ECOG) scale, Macdonald criteria, and the Response Assessment in Neuro-Oncology (RANO) criteria to patients at the time of diagnosis as well as at 3, 6, and 12 mo.ResultsInitial NANO score was correlated with overall survival at time of presentation. NANO progression was correlated with decreased survival in patients at 6 and 12 mo. A decrease in KPS was associated with survival at 3 and 6 mo, an increase in ECOG score was associated only at 3 mo, and radiological evaluation (RANO and Macdonald) was correlated at 3 and 6 mo. Only the NANO scale was associated with patient survival at 1 yr. NANO progression was the only metric that was linked to decreased overall survival when compared to RANO and Macdonald at 6 and 12 mo.ConclusionThe NANO scale is specific to neuro-oncology and can be used to assess patients with glioma. This retrospective analysis demonstrates the usefulness of the NANO scale in glioblastoma.Copyright © 2018 by the Congress of Neurological Surgeons.

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