Evaluation of neuropsychological outcome and "quality of life" after glioma surgery.

Abstract

Extended tumour resection is imperative to improve the outcome of glioma patients but also carries the risk of increasing morbidity and thus, potentially, of decreasing the patient's quality of life (QOL). In this pilot study, we evaluated how postoperative neurological and neuropsychological alterations impacted on QOL in patients who underwent glioma resection. Twenty-two patients were included in this study and tested at three different time points, i.e. 1day before surgery (t1), on the day of discharge (t2) and 3months following surgery (T3). National Institutes of Health Stroke Scale (NIHSS) score, Addenbrook's Cognitive Examination-Revised (ACE-R) and a comprehensive battery of established tests were used to assess neurological and neuropsychological profiles. QOL and subjectively experienced health condition were ascertained through the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC-QLQ C30) and EORTC-QLQ BN20 questionnaires. Postoperatively, 5/22 patients worsened and 5/22 patients improved neurologically. Depending on the neuropsychological test, up to 57.1% of patients experienced deterioration of some sort of neuropsychological function. Most of these functions, however, recovered during the extended observation period (3months). There was no correlation between QOL and a patient's neurological or neuropsychological condition. Our study suggests that extended tumour resection is not necessarily linked to a loss in QOL.