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Peer-reviewedCC BYInterdisciplinary Neurosurgery

Beyond independent predictors: interrelationships among preoperative characteristics associated with surgical complexity in insular gliomas

  • Valentyn Kliuchka
  • Artem Rozumenko1
  • Volodymyr Rozumenko1
  • Oleksandr Lisianyi1
  • Anatoly Andrukhiv1
  • Tetyana Malysheva2
  • Volodymyr Shutka3
  • Oleg Dyma2
  1. 1Department of Innovative Neurosurgical Technologies, The State Institution Romodanov Neurosurgery Institute, National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
  2. 2Department of Neuropathomorphology, The State Institution Romodanov Neurosurgery Institute, National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
  3. 3Department of Traumatology, Orthopedics and Neurosurgery, Bukovinian State Medical University, Chernivtsy, Ukraine
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Abstract

Objective: Preoperative spatial characteristics of insular gliomas are commonly analyzed as separate predictors of surgical outcome, although several may describe overlapping aspects of tumor growth. This study examined the interrelationships among routinely assessed spatial characteristics and evaluated their individual and adjusted associations with achievable extent of resection. Methods: This retrospective single-center study included 167 consecutive patients who underwent surgery for histopathologically confirmed insular gliomas between 2017 and 2024. Preoperative variables included tumor size, multizonal involvement, extrainsular extension, and Berger–Sanai topography. Relationships among tumor size, multizonal involvement, and extrainsular extension were assessed using Spearman correlation coefficients. Associations with partial resection (<90%) were evaluated using univariable and multivariable logistic regression. Multicollinearity was assessed using variance inflation factors and tolerance values. Postoperative WHO grade was evaluated separately in a sensitivity analysis. Results: Tumor size correlated with multizonal involvement (ρ = 0.640, p < 0.001) and extrainsular extension (ρ = 0.609, p < 0.001), while multizonal involvement correlated with extrainsular extension (ρ = 0.497, p < 0.001). Multicollinearity diagnostics were acceptable (VIF 1.34–3.03). In multivariable analysis, tumor size 3–5 cm (OR 3.98, 95% CI 1.29–12.24), tumor size >5 cm (OR 17.37, 95% CI 3.36–89.87), and multizonal involvement (OR 5.16, 95% CI 2.06–12.95) remained independently associated with partial resection. Associations of extrainsular extension and Berger–Sanai zones were attenuated after adjustment. Conclusions: Preoperative spatial characteristics of insular gliomas provide partially overlapping information. Tumor size and multizonal involvement retained independent associations with partial resection, supporting consideration of both tumor extent and spatial distribution when estimating achievable resection.

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Cite

BibTeXRIS
BibTeX
@article{kliuchka2026beyond,
  title = {{Beyond independent predictors: interrelationships among preoperative characteristics associated with surgical complexity in insular gliomas}},
  author = {Valentyn Kliuchka and Artem Rozumenko and Volodymyr Rozumenko and Oleksandr Lisianyi and Anatoly Andrukhiv and Tetyana Malysheva and Volodymyr Shutka and Oleg Dyma},
  journal = {Interdisciplinary Neurosurgery},
  year = {2026},
  month = oct,
  doi = {10.1016/j.inat.2026.102405},
  url = {https://doi.org/10.1016/j.inat.2026.102405},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Beyond independent predictors: interrelationships among preoperative characteristics associated with surgical complexity in insular gliomas
AU  - Valentyn Kliuchka
AU  - Artem Rozumenko
AU  - Volodymyr Rozumenko
AU  - Oleksandr Lisianyi
AU  - Anatoly Andrukhiv
AU  - Tetyana Malysheva
AU  - Volodymyr Shutka
AU  - Oleg Dyma
PY  - 2026
DA  - 2026/10/30
JO  - Interdisciplinary Neurosurgery
DO  - 10.1016/j.inat.2026.102405
UR  - https://doi.org/10.1016/j.inat.2026.102405
AB  - Objective: Preoperative spatial characteristics of insular gliomas are commonly analyzed as separate predictors of surgical outcome, although several may describe overlapping aspects of tumor growth. This study examined the interrelationships among routinely assessed spatial characteristics and evaluated their individual and adjusted associations with achievable extent of resection. Methods: This retrospective single-center study included 167 consecutive patients who underwent surgery for histopathologically confirmed insular gliomas between 2017 and 2024. Preoperative variables included tumor size, multizonal involvement, extrainsular extension, and Berger–Sanai topography. Relationships among tumor size, multizonal involvement, and extrainsular extension were assessed using Spearman correlation coefficients. Associations with partial resection (<90%) were evaluated using univariable and multivariable logistic regression. Multicollinearity was assessed using variance inflation factors and tolerance values. Postoperative WHO grade was evaluated separately in a sensitivity analysis. Results: Tumor size correlated with multizonal involvement (ρ = 0.640, p < 0.001) and extrainsular extension (ρ = 0.609, p < 0.001), while multizonal involvement correlated with extrainsular extension (ρ = 0.497, p < 0.001). Multicollinearity diagnostics were acceptable (VIF 1.34–3.03). In multivariable analysis, tumor size 3–5 cm (OR 3.98, 95% CI 1.29–12.24), tumor size >5 cm (OR 17.37, 95% CI 3.36–89.87), and multizonal involvement (OR 5.16, 95% CI 2.06–12.95) remained independently associated with partial resection. Associations of extrainsular extension and Berger–Sanai zones were attenuated after adjustment. Conclusions: Preoperative spatial characteristics of insular gliomas provide partially overlapping information. Tumor size and multizonal involvement retained independent associations with partial resection, supporting consideration of both tumor extent and spatial distribution when estimating achievable resection.
SN  - 2214-7519
ER  -