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

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 posto...

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Veröffentlicht in:World neurosurgery 2018-09, Vol.117, p.e465-e474
Hauptverfasser: Drewes, Christina, Sagberg, Lisa Millgård, Jakola, Asgeir Store, Solheim, Ole
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Sprache:eng
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Zusammenfassung: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. 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. 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. 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. •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.
ISSN:1878-8750
1878-8769
DOI:10.1016/j.wneu.2018.06.052