Abstract
OBJECTIVE: Depression and neurocognitive function (NCF), particularly executive functioning (EF), have been associated with overall survival (OS) in patients with glioblastoma (GBM). However, the combined effect of depression and impaired EF has not been reported. METHODS: Patients with GBM (n = 102) completed neuropsychological assessment postoperatively (mean = 23.5 days post surgery) including the Beck Depression Inventory-Second Edition (BDI-II) and the Trail Making Test Part B (TMTB). Median splits were used to determine cut-points indicating the presence of elevated depressive symptoms on the BDI-II (BDI-II > 8) and executive impairment on TMTB (demographically-adjusted z-score 50, neither KPS nor age modified the independent effect of BDI-II and TMTB on OS in cox regression models. CONCLUSION: The presence of depressive symptoms and impaired EF are independently associated with shorter survival in patients with GBM. This retrospective analysis was unable to determine if these factors were independent of tumor molecular markers. Routine neuropsychological assessment of mood and cognition can help refine prognosis and facilitate initiation of psychological and cognitive interventions, which are likely to improve patient quality of life and may extend survival time.
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