The Indonesian Version of the Neurological Assessment in Neuro-Oncology (NANO-Ina) Scale and Karnofsky Performance Scale (KPS) as Instruments for Assessing Postoperative Response in Meningioma and Its Influencing Factors

Aninditha, Tiara; Angelita, Michelle Cancera; Tandian, David; Rasyid, Al; Safri, Ahmad Yanuar; Sofyan, Henry Riyanto; Savitri, Irma; Andriani, Rini

doi:10.31557/APJCP.2026.27.10.3565

The Indonesian Version of the Neurological Assessment in Neuro-Oncology (NANO-Ina) Scale and Karnofsky Performance Scale (KPS) as Instruments for Assessing Postoperative Response in Meningioma and Its Influencing Factors

Document Type : Research Articles

Authors

¹ Department of Neurology, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

² Department of Neurosurgery, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

³ Department of Neurology, Dharmais Cancer Hospital, Jakarta, Indonesia.

10.31557/APJCP.2026.27.10.3565

Abstract

Objective: This study aimed to evaluate whether the NANO-Ina scale and the Karnofsky Performance Scale (KPS) can be used as instruments for assessing postoperative response in meningioma patients.Methods: This prospective cohort study was conducted among intracranial meningioma patients who underwent surgery at RSUPN Cipto Mangunkusumo and Dharmais Cancer Hospital from October 2024 to February 2025. Data collected included demographic, clinical, and tumor characteristics. The NANO-Ina scale and KPS were assessed before and after surgery. Statistical analysis included bivariate comparative tests followed by logistic regression and correlation tests. Result: A total of 52 subjects were included in this study, with a median age of 46 years (range: 33-61). The majority of subjects were female (90.4%), with the most common tumor location at the cranial base (69.2%), using perioperative steroids (75%), grade I histopathology (96.2%), and subtotal resection performed (73.1%). The mean NANO-Ina scores before and after surgery were 2.54±2.35 and 2.15±1.9 (p=0.024), respectively, while the KPS scores were 80.8±12.2 and 82.9±11.6 (p=0.015). There was a strong correlation between pre- and postoperative clinical performance, with NANO-Ina scale (r=0.817; p<0.001) and KPS (r=0.831; p<0.001). The only factor associated with postoperative NANO-Ina improvement was the preoperative NANO-Ina score. Factors associated with postoperative KPS included age, extent of tumor resection, and preoperative KPS. Conclusion: Preoperative NANO-Ina scale and KPS scores are associated with postoperative improvement, and a very strong correlation was observed between pre- and postoperative scores on both the NANO-Ina scale and KPS.

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