Perioperative and Postoperative Quality of Life in Patients with Glioma–A Longitudinal Cohort Study

Drewes, Christina; Sagberg, Lisa Millgård; Jakola, Asgeir Store; Solheim, Ole

doi:10.1016/j.wneu.2018.06.052

Cited by 31 publications

(31 citation statements)

References 26 publications

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“…Low-grade histology was another independent factor for postoperative high fatigue, and patients with LGG had higher median postoperative fatigue scores, whereas the HGG group had stable median fatigue scores one month after surgery. This may seem surprising considering the poorer prognosis and often lower functional status in HGG patients [37]. Since most of the patients who were lost to follow up had HGG, selection bias may be an issue.…”

Section: Discussionmentioning

confidence: 99%

Perioperative fatigue in patients with diffuse glioma

et al. 2020

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Purpose Few studies have assessed fatigue in relation to glioma surgery. The purpose of this study was to explore the prevalence of pre-and postoperative high fatigue, perioperative changes, and factors associated with pre-and postoperative high fatigue in patients undergoing primary surgery for diffuse glioma. Methods A total of 112 adult patients were prospectively included. Patient-reported fatigue was assessed before and one month after surgery using the cancer-specific European Organization for Research and Treatment of Cancer questionnaire fatigue subscale. The scores were dichotomized as high fatigue (≥ 39) or low fatigue (< 39). A change in score of ≥ 10 was considered as a clinically significant change. Factors associated with pre-and postoperative high fatigue were explored in multivariable regression analyses. Results High fatigue was reported by 45% of the patients preoperatively and by 42% of the patients postoperatively. Female gender and low Karnofsky Performance Status (KPS) were associated with preoperative high fatigue, while postoperative complications, low KPS and low-grade histopathology were associated with postoperative high fatigue. In total 35/92 (38%) patients reported a clinically significant improvement of fatigue scores after surgery, 36/92 (39%) patients reported a clinically significant worsening of fatigue scores after surgery, and 21/92 (23%) patients reported no clinically significant change in fatigue scores after surgery. Patients with low-grade gliomas more often reported low fatigue before surgery and high fatigue after surgery, while patients with high-grade gliomas more often reported high fatigue before surgery and low fatigue after surgery. Conclusions Our findings indicate that fatigue is a common symptom in patients with diffuse glioma, both pre-and postoperatively. Perioperative changes were frequently seen. This is important knowledge when informing patients before and after surgery.

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Section: Discussionmentioning

confidence: 99%

Perioperative fatigue in patients with diffuse glioma

et al. 2020

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“…Former studies have already provided evidence that cognitive performance is an important predictor of QoL and (progression free) survival. 7-9 Also, cognitive performance of glioma patients (assessed with neuropsychological tests) has been found to be generalizable to “real-world” functions and activities, 49 resulting in for example slow responses to stimuli (related to Reaction Time) and struggles with adapting to new or changing events (related to Cognitive Flexibility), thereby complicating the ability of patients to perform everyday activities such as driving a car or preparing diner. We advocate the implementation of a preoperative and 3-mo postoperative NPA into the clinical care of GBM patients to gain insight into cognitive functioning and to guide in clinical decision-making.…”

Section: Discussionmentioning

confidence: 99%

Presurgical Identification of Patients With Glioblastoma at Risk for Cognitive Impairment at 3-Month Follow-up

et al. 2020

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BACKGROUND Pre- and postoperative cognitive deficits have repeatedly been demonstrated in patients with glioblastoma (GBM). OBJECTIVE To identify presurgical risk factors that facilitate the identification of GBM patients at risk for postoperative cognitive impairment. METHODS Patients underwent neuropsychological assessment using Central Nervous System Vital Signs 1 d before (T0) and 3 mo after surgery (T3). Patients’ standardized scores on 7 cognitive domains were compared to a normative sample using one-sample z tests. Reliable change indices with correction for practice effects were calculated to assess cognitive changes in individual patients over time. Logistic regression models were performed to assess presurgical sociodemographic, clinical, psychological, and cognitive risk factors for postoperative cognitive impairments. RESULTS At T0, 208 patients were assessed, and 136 patients were retested at T3. Patients showed significantly lower performance both prior to and 3 mo after surgery on all cognitive domains compared to healthy controls. Improvements and declines over time occurred respectively in 11% to 32% and 6% to 26% of the GBM patients over the domains. The regression models showed that low preoperative cognitive performance posits a significant risk factor for postoperative cognitive impairment on all domains, and female sex was a risk factor for postoperative impairments in Visual Memory. CONCLUSION We demonstrated preoperative cognitive risk factors that enable the identification of GBM patients who are at risk for cognitive impairment 3 mo after surgery. This information can help to inform patients and clinicians at an early stage, and emphasizes the importance of recognizing, assessing, and actively dealing with cognitive functioning in the clinical management of GBM patients.

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“…[24] Both high- and low-grade gliomas did not find any difference in QOL measures at baseline preoperatively, though subjective individual factors vary. [25]…”

Section: Discussionmentioning

confidence: 99%

Psychiatric and cognitive correlates of quality of life among persons with primary brain tumors

Srivastava¹,

Bhatia²,

Gaur³

et al. 2019

Ind Psychiatry J

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Background:Quality of life (QoL) in primary brain tumour (PBT) is often the main outcome measure in an otherwise incurable disease. The impact of psychiatric, cognitive correlates on quality of life in primary brain tumours is less well studied.Aims and objectives:The primary objective was to find out the association of psychiatric morbidity, cognitive functions with quality of life in patients with primary brain tumours. The secondary objective was to study whether any association exists with tumour grading, laterality, location and psychiatric morbidity.Materials and Methods:100 consecutive patients of PBT were screened in the Neuro-behavioural Clinic. Age, gender matched 52 healthy subjects were taken for comparison. Quality of life (qol) measure (EORTC), Hospital Anxiety Depression Scale (HADS), GHQ (12 item) and Mini Mental State Examination (MMSE) were administered.Results:52 PBT cases were included, out of which 17.30% had Organic Anxiety Disorder (F06.4), 23.07% had Organic Mood disorder (F06.3%).Statistically significant association was found in EORTC qol scores and anxiety scores (p 0.001), depressive scores (p 0.029), psychiatric morbidity (p0.000) .Significant association with tumour laterality, depression scores (p0.041) was found. PBT patients had poor quality of life as compared to matched healthy volunteers (p <0.001). Significant negative correlation between EORTC B-20, cognitive scores using Spearman's Rho (p0.005; r - 0.385), implying more symptoms with poor cognitive function scores. Psychiatric morbidity, cognitive dysfunction, poor qol were noted, though no association with tumour grading, location.Conclusion:Regular assessments, early intervention will help in improving quality of life in PBT.

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Perioperative and Postoperative Quality of Life in Patients with Glioma–A Longitudinal Cohort Study

Cited by 31 publications

References 26 publications

Perioperative fatigue in patients with diffuse glioma

Perioperative fatigue in patients with diffuse glioma

Presurgical Identification of Patients With Glioblastoma at Risk for Cognitive Impairment at 3-Month Follow-up

Psychiatric and cognitive correlates of quality of life among persons with primary brain tumors

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