Abstract
Simple SummaryLow-grade gliomas (LGGs) comprise 13–16% of glial tumors. As survival for LGG patients has been improving, it is important to consider the effects of diagnosis and treatment on mental health. The aims of this retrospective cohort study were to determine the incidence, prevalence, and risk factors of mental health disorders (MHD) in LGG patients. In our analysis including 20,432 LGG patients, we identified an MHD prevalence of 60.9%. Of those with no history of prior MHD, 16.9% of LGG patients developed a new onset of MHD within 12 months of LGG diagnosis. Risk factors included female gender, ages 35–54, presence of seizures, and first-line surgical treatment. Therefore, proactive surveillance and counseling surrounding MHDs are recommended among LGG patients. Impact of surgery on brain networks affecting mood should also be considered.Low-grade gliomas (LGGs) comprise 13–16% of glial tumors. As survival for LGG patients has been gradually improving, it is essential that the effects of diagnosis and disease progression on mental health be considered. This retrospective cohort study queried the IBM Watson Health MarketScan® Database to describe the incidence and prevalence of mental health disorders (MHDs) among LGG patients and identify associated risk factors. Among the 20,432 LGG patients identified, 12,436 (60.9%) had at least one MHD. Of those who never had a prior MHD, as documented in the claims record, 1915 (16.7%) had their first, newly diagnosed MHD within 12 months after LGG diagnosis. Patients who were female (odds ratio (OR), 1.14, 95% confidence intervals (CI), 1.03–1.26), aged 35–44 (OR, 1.20, 95% CI, 1.03–1.39), and experienced glioma-related seizures (OR, 2.19, 95% CI, 1.95–2.47) were significantly associated with MHD incidence. Patients who underwent resection (OR, 2.58, 95% CI, 2.19–3.04) or biopsy (OR, 2.17, 95% CI, 1.68–2.79) were also more likely to develop a MHD compared to patients who did not undergo a first-line surgical treatment. These data support the need for active surveillance, proactive counseling, and management of MHDs in patients with LGG. Impact of surgery on brain networks affecting mood should also be considered.
Highlights
Low-grade gliomas (LGGs, WHO Grade II gliomas) comprise 13–16% of all glial tumors [1]
The objective of this study was to leverage a commercial healthcare claims database to: (1) describe the prevalence of a broad spectrum of mental health disorders (MHDs) among LGG patients, (2) determine if there is a temporal correlation between LGG diagnosis and increased MHD incidence, and (3) identify associated risk factors for MHDs among the LGG cohort, including first-line treatment modality and presence of seizures
We considered an MHD present after LGG diagnosis if found in the claims records within 12 months after the index diagnosis; this timing captured diagnoses likely associated with the cancer diagnosis and treatment, while minimizing other confounding life events
Summary
Low-grade gliomas (LGGs, WHO Grade II gliomas) comprise 13–16% of all glial tumors [1]. LGGs comprise a heterogeneous group of tumors that inevitably undergo malignant transformation, leading to neurological deterioration and death [2]. The mean length of survival of patients with LGGs has classically been less than 10 years post-diagnosis, ranging between 3.2 and 7.7 years among different prognostic groups [3]. Due to their frequent origin in eloquent brain areas and relatively mild or absent neurological symptoms early on, LGGs have historically been treated with a wait-and-see approach to mitigate risk [3]. As the profile of LGG shifts to a more chronic condition with gradually improving survival, it is essential that the effects of diagnosis and treatment on quality of life (QoL) be considered
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