Neuropsychological outcomes following supratotal resection for high‐grade glioma: a review

Tabor, Joanna K; Bonda, David J.; LeMonda, Brittany C.; D’Amico, Randy S.

doi:10.1007/s11060-021-03731-9

Cited by 17 publications

(16 citation statements)

References 48 publications

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“…3 Main complaint (include multiple responses) of patients with RCS < 40. They could be divided into three categories, function related issues which was the highest percentage (41%), work related issues, and disease or treatment related issues synonymous [28][29][30], while others have suggested that functional factors and QOL are not related or that functional factors alone cannot fully explain the outcome [31,32]. Accordingly, KPS = 100 signified significantly higher QOL than KPS ≤ 90 in our patient group (Online Resource 5).…”

Section: Discussionmentioning

confidence: 81%

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Quality of life following awake surgery depends on ability of executive function, verbal fluency, and movement

et al. 2021

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IntroductionThe outcome of awake surgery has been evaluated based on functional factors, return to work, and oncological aspects, and there have been no reports directly examining QOL. This study aimed to investigate the outcome of QOL following awake surgery and to determine the functional factors influencing QOL. Methods Seventy patients with WHO grade II/III gliomas were included. For the assessment of QOL, we used the SF-36 and calculated summary and sub-component scores. Three summary component scores, including physical (PCS), mental (MCS), and role/social summary (RCS) component scores, were computed based on sub-component scores. Additionally, various assessments of neurological/neuropsychological function were performed. We performed univariate and multiple regression analyses to investigate the functional factors influencing the SF-36. Results PCS and MCS were maintained, but only RCS was low to 42.0 ± 16.1. We then focused on the RCS and its subcomponents: general health (GH), role physical (RP), social functioning (SF), and role emotional (RE). Multiple regression analysis showed following significant correlations between the sub-component scores and brain functions: GH to executive function and movement (p = 0.0033 and 0.032), RP to verbal fluency and movement (p = 0.0057 and 0.0010), and RE to verbal fluency (p = 0.020). Furthermore, when the sub-component scores were compared between groups with and without functional deficits related to GH, RP, and RE, each score was significantly lower in the groups with functional deficits (p = 0.012, 0.014, and 0.0049, respectively). Conclusions In patients who underwent awake surgery, a subset of patients had low QOL because of poor RCS. Functional factors influencing QOL included executive function, verbal fluency, and movement.

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Section: Discussionmentioning

confidence: 81%

“…Similarly, the term functional outcome was sometimes used as synonymous with QOL [28][29][30]. However, functional outcomes such as Karnofsky Performance Status (KPS) and neuropsychological function do not necessarily conform with QOL in clinical practice [31,32].…”

Section: Introductionmentioning

confidence: 99%

Quality of life following awake surgery depends on ability of executive function, verbal fluency, and movement

et al. 2021

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“…Currently, the concept of supratotal maximal resection (SMR), which is termed as total removal of both CE and T2/FLAIR abnormal regions for eligible patients, has raised great interest in neurosurgeons for GBM treatment. Some retrospective studies demonstrated that patients with GBM might derive a survival benefit from SMR while some were not (36)(37)(38)(39)(40)(41)(42)(43)(44). GBMs appropriate for SMR are commonly located on the prefrontal lobe, where a high percentage of GBMs was glioma-CpG island methylator phenotype (G-CIMP) subtype and MGMT promoter methylated (45,46).…”

Section: Discussionmentioning

confidence: 99%

T2/FLAIR Abnormity Could be the Sign of Glioblastoma Dissemination

Huang

Chen

et al. 2022

Front. Neurol.

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PurposeNewly emerged or constantly enlarged contrast-enhancing (CE) lesions were the necessary signs for the diagnosis of glioblastoma (GBM) progression. This study aimed to investigate whether the T2-weighted-Fluid-Attenuated Inversion Recovery (T2/FLAIR) abnormal transformation could predict and assess progression for GBMs, especially for tumor dissemination.MethodsA consecutive cohort of 246 GBM patients with regular follow-up and sufficient radiological data was included in this study. The series of T2/FLAIR and T1CE images were retrospectively reviewed. The patients were separated into T2/FLAIR and T1CE discordant and accordant subgroups based on the initial progression images.ResultsA total of 170 qualified patients were finally analyzed. The incidence of discordant T2/FLAIR and T1CE images was 25.9% (44/170). The median time-span of T2/FLAIR indicated tumor progression was 119.5 days (ranging from 57 days-unreached) prior to T1CE. Nearly half of patients (20/44, 45.5%) in the discordant subgroup suffered from tumor dissemination, substantially higher than accordant patients (23/126, 20.6%, p < 0.001). The median time to progression (TTP), post-progression survival (PPS), and overall survival (OS) were not statistically different (all p > 0.05) between discordant and accordant patients.ConclusionsT2/FLAIR abnormity could be the sign of GBM progression, especially for newly emerged lesions disseminating from the primary cavity. Physicians should cast more attention on the dynamic change of T2/FLAIR images, which might be of great significance for progression assessment and subsequent clinical decision-making.

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“…In the most recent review on supratotal resection of high-grade glioma Tabor et al. reported on a decline in all neurocognitive domains immediately after surgery with return to baseline after a follow-up period of 1 to 4 months, with the exception of memory ( 36 ). Another meta-analysis on neuro-cognition after glioma surgery, including both low- and high-grade glioma patients, reported on improved language, attention and memory already in the immediate postoperative period, whereas executive function showed sustained decline also at long-term follow-up 3 to 6 months after surgery ( 37 ).…”

Section: Discussionmentioning

confidence: 99%

Neurocognitive Outcome and Seizure Freedom After Awake Surgery of Gliomas

et al. 2022

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ObjectivesGliomas are often diagnosed due to epileptic seizures as well as neurocognitive deficits. First treatment choice for patients with gliomas in speech-related areas is awake surgery, which aims at maximizing tumor resection while preserving or improving patient’s neurological status. The present study aimed at evaluating neurocognitive functioning and occurrence of epileptic seizures in patients suffering from gliomas located in language-related areas before and after awake surgery as well as during their follow up course of disease.Materials and MethodsIn this prospective study we included patients who underwent awake surgery for glioma in the inferior frontal gyrus, superior temporal gyrus, or anterior temporal lobe. Preoperatively, as well as in the short-term (median 4.1 months, IQR 2.1-6.0) and long-term (median 18.3 months, IQR 12.3-36.6) postoperative course, neurocognitive functioning, neurologic status, the occurrence of epileptic seizures and number of antiepileptic drugs were recorded.ResultsBetween 09/2012 and 09/2019, a total of 27 glioma patients, aged 36.1 ± 11.8 years, were included. Tumor resection was complete in 15, subtotal in 6 and partial in 6 patients, respectively. While preoperatively impairment in at least one neurocognitive domain was found in 37.0% of patients, postoperatively, in the short-term, 36.4% of patients presented a significant deterioration in word fluency (p=0.009) and 34.8% of patients in executive functions (p=0.049). Over the long-term, scores improved to preoperative baseline levels. The number of patients with mood disturbances significantly declined from 66.7% to 34.8% after surgery (p=0.03). Regarding seizures, these were present in 18 (66.7%) patients prior to surgery. Postoperatively, 22 (81.5%) patients were treated with antiepileptic drugs with all patients presenting seizure-freedom.ConclusionsIn patients suffering from gliomas in eloquent areas, the combination of awake surgery, regular neurocognitive assessment - considering individual patients´ functional outcome and rehabilitation needs – and the individual adjustment of antiepileptic therapy results in excellent patient outcome in the long-term course.

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Neuropsychological outcomes following supratotal resection for high‐grade glioma: a review

Cited by 17 publications

References 48 publications

Quality of life following awake surgery depends on ability of executive function, verbal fluency, and movement

Quality of life following awake surgery depends on ability of executive function, verbal fluency, and movement

T2/FLAIR Abnormity Could be the Sign of Glioblastoma Dissemination

Neurocognitive Outcome and Seizure Freedom After Awake Surgery of Gliomas

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