Abstract
ObjectiveAt present, it is not clear whether Mood Disorders (MD) and poor Health Related Quality of Life (HRQoL) in the glioma population correlate with features of the tumor, or rather with secondary symptoms associated with treatment. The aim of this study was to assess the prevalence of MD and decline in HRQoL in glioma patients, and to determine the main factors associated with these two variables.Methods80 patients affected by lower-grade gliomas (LGGs) and 65 affected by high-grade gliomas (HGGs) were evaluated, from admission up to 12 months after surgery, for MD, HRQoL, clinical characteristics, and cognitive functions. Independent factors associated with MD and low HRQoL were identified by using bivariate analysis.ResultsData showed that prevalence of low HRQoL was comparable in both groups during all the time points assessed (pre, 1, 3, 6 and 12 months after surgery). In contrast at 6 months following surgery, HGGs showed a higher prevalence of MD compared to LGGs;. Bivariate analysis revealed that factors associated with MD and HRQoL in LGGs and HGGs were different over the course of the disease. In LGGs, from the pre-operative period to one year post surgery, MD and low HRQOL were associated with the occurrence of cognitive deficits and, from the third month after surgery onward, they were also associated with the effect exerted by adjuvant treatments. In HGGs, MD were associated with cognitive deficits at 3 and 6 months after surgery, along with older age (65-75 years); HRQoL, in its Physical component in particular, was associated with older age only from 6 months after surgery.ConclusionFactors associated with MD and low HRQoL were different in LGGs and HGGs over the course of the disease. In LGGs the effect of adjuvant treatments was prominent in determining the prevalence of both MD and poor HRQoL from the third month after surgery onward. In HGGs, MD and HRQoL were associated with age, at 3 and 6 months after surgery. In both, the occurrence of cognitive deficits was significantly associated with MD.
Highlights
Gliomas are primary brain tumors that have a variable prognosis
Bivariate analysis revealed that factors associated with Mood Disorders (MD) and health related quality of life (HRQoL) in lower-grade gliomas (LGGs) and high-Grade Gliomas (HGGs) were different over the course of the disease
In LGGs, from the pre-operative period to one year post surgery, MD and low HRQOL were associated with the occurrence of cognitive deficits and, from the third month after surgery onward, they were associated with the effect exerted by adjuvant treatments
Summary
For patients with glioblastoma (15 months-2 years), other high-Grade Gliomas (HGGs) such as astrocytoma or oligodendroglioma anaplastic (3-10 years) or lower-grade gliomas (LGGs; 7-15 years) [1]. Such variance depends on several factors, such as the biological behavior of the tumors, age of the patient, and treatment(s) adopted [2]. MD is reported to range between 2.8% to 95% for depression, and between 13% to 60% for anxiety [11,12,13] Such wide variance may be associated with multiple factors, either clinical (treatment, histology, location) or functional (neurological and cognitive dysfunctions). 45% of patients with a lower-grade glioma report a low global (poor) quality of life, with fewer than half of patients being able to carry out daily life activities without restriction [15]
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