Elsevier

World Neurosurgery

Volume 117, September 2018, Pages e465-e474
World Neurosurgery

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

https://doi.org/10.1016/j.wneu.2018.06.052Get rights and content
Under a Creative Commons license
open access

Highlights

  • Stable group-level QoL in LGG during 6-month period after surgery.

  • QoL in HGG stable at 1 month but deteriorates at 6 months.

  • Heterogeneous QoL development at individual level.

  • Non-GTR and comorbidity predict negative postoperative dynamics.

Objective

Few studies have assessed patient-reported quality of life (QoL) in patients with glioma undergoing surgery, and even fewer have provided longitudinal data. Accordingly, there is little knowledge about the changes of QoL over time in patients with glioma. We sought to explore perioperative and postoperative development of generic QoL during the first 6 months after primary glioma surgery.

Methods

A total of 136 adult patients undergoing primary surgery for high-grade glioma (HGG) or low-grade glioma (LGG) were prospectively included in this explorative longitudinal study. Patient-reported QoL was measured with the generic tool EQ-5D 3L preoperatively and at 1 and 6 months after surgery.

Results

At group level, there was no difference in EQ-5D index values in patients with HGG compared with patients with LGG at baseline or at 1 month. At 6 months, EQ-5D index values in patients with HGG had deteriorated significantly (P < 0.001) but remained stable in patients with LGG. Individual level QoL development was more diverse. American Society of Anesthesiologists class ≥3, resection grades other than gross total resection, and HGG were identified as independent predictors for negative development of QoL between 1 and 6 months after surgery.

Conclusions

At group level, development of generic QoL between baseline and 1 and 6 months postoperatively seems to follow the natural disease trajectories of LGG and HGG, with deterioration in patients with HGG at 6 months. Individual development of QoL is heterogeneous. HGG, resection grades other than gross total resection, and preoperative comorbidity are predictors of postoperative impairment of QoL.

Key words

Brain neoplasms
Glioma
Oncology
Patient-reported outcome measures
Quality of life

Abbreviations and Acronyms

ASA
American Society of Anesthesiologists
GTR
Gross total resection
HGG
High-grade glioma
IDH
Isocitrate dehydrogenase
LGG
Low-grade glioma
MCID
Minimal clinically important difference
QoL
Quality of life

Cited by (0)

Conflict of interest statement: C.D. received a grant from St. Olavs Hospital, Trondheim, Norway (reference 15/9116-135).