Evaluation of neurological outcome and quality of life after extended resection of gliomas

Abstract

Objective To evaluate the neurological, neuropsychological and quality of life (QOL) alterations in patients who underwent extended resection of gliomas. Methods From January 2014 to November 2015, a total of 58 patients with gliomas were admitted to Department of Neurosurgery, the First Affiliated Hospital of Nanjing Medical University, and were enrolled into this study. Extended resection was performed in all patients. Patients were assessed at 3 time points, i. e. 1 day before surgery (T1), the day of discharge (T2) and 3 months post surgery (T3). National Institutes of Health Stroke Scale (NIHSS) score, Addenbrooke cognitive examination-revised (ACE-R), Hospital Anxiety and Depression (HAD) and neuropsychological test battery (NTB) were used to assess neurological and neuropsychological profiles. QOL was ascertained through the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC-QLQ C30). Results At T1 (58 cases), T2 (50 cases) and T3 (46 cases), the patient’s overall QOL score was 67.8 (48.9, 86.7), 66.7 (47.5, 85.9) and 64.8 (41.4, 88.5), respectively. There was no significant difference between different time periods (P>0.05). At T3, 24% (11/46) of the patients showed worsened neurological functions and 28% (13/46) gained neurological improvement compared with pre-operative conditions. According to the neuropsychological test, 65% (13/50) experienced deterioration of neuropsychological functions to varying degrees. However, those functions recovered at T3 for majority of patients. Conclusions Extended resection of gliomas does not seem to result in deterioration of QOL of patients. Patients undergoing extended resection might experience deterioration of neurological and neuropsychological functions in the early postoperative period, which could recover to preoperative levels after some time in most cases. Key words: Glioma; Neuropsychiatry; Quality of life; Extended resection