Abstract
BACKGROUND: Deterioration of health-related quality of life (HRQOL) and cognitive function is a major concern in patients who underwent glioma surgery. While HRQOL is influenced by both tumor and non-tumor factors, the influence of molecular genetic features on HRQOL is not fully understood. Here we investigated the relations among HRQOL, cognitive function, and genotypes during high grade glioma surgery. METHODS: Consecutive patients who underwent glioma surgery were evaluated with HRQOL scores (EORTC QLQ-C30 and BN20 brain cancer modules) and cognitive function tests (digit span tests, verbal fluency, and the Trail Making Tests parts A and B) at both preoperative and postoperative time points. Tumor were evaluated for genotypes including IDH1/IDH2 mutation, 1p/19q deletion, MGMT promoter methylation, epidermal growth factor receptor (EGFR) amplification, phosphatase and tensin homolog (PTEN) loss, and c-Met expression. Patients with high grade glioma were included into the final analysis. Results: Total 61 patients were diagnosed with high grade glioma. The preoperative HRQOL and cognitive functions were not different between the gene mutant and non-mutant tumors. However, postoperative HRQOL (BN20, physical functioning, and communication deficits) and cognitive functions (Trail Making Tests, and verbal fluency) were better in the IDH-1 mutant tumors compared to the IDH-1 wild-type tumors. The associations between IDH-1 mutation, better HRQOL and cognitive functions were independent from other tumor and non-tumor factors such as age, performance score, tumor size, tumor locations, extent of resection, and other mutations. Other genetic features were not related to the HRQOL and cognitive function. CONCLUSION: The postoperative deterioration in HRQOL and cognitive functions is minimal in IDH-1 mutant high grade glioma. This might be related with a preoperative cortical remodeling in the secondary glioma, or other innate metabolic microenvironment in IDH-1 mutant tumors.
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