Abstract
Simple SummaryAsymptomatic meningiomas are found in 1–2% of cranial MRIs. Most of them demonstrate no or minimal growth and are observed with follow-up imaging. However, the patients face a diagnosis of a brain tumor. So far, there is no established distress screening for such patients. In this study, we evaluated the psychological burden of patients with small asymptomatic meningiomas and compared it with patients after complete meningioma resection and excellent postoperative outcome. We found a high prevalence of anxiety and depression symptoms in both study groups. This demonstrates that even patients with benign asymptomatic intracranial tumors might be under significant distress and need psychooncological support. The diagnosis of intracranial meningiomas as incidental findings is increasing by growing availability of MRI diagnostics. However, the psychological distress of patients with incidental meningiomas under a wait-and-watch strategy is unknown. Therefore, we aimed to compare the psychosocial situation of meningioma patients under wait-and-watch to patients after complete resection to bridge this gap. The inclusion criteria for the prospective monocenter study were either an incidental meningioma under a wait-and-watch strategy or no neurologic deficits after complete resection. Sociodemographic, clinical, and health-related quality of life and clinical data were assessed. Psychosocial factors were measured by the Distress Thermometer (DT), Hospital Anxiety and Depression Scale (HADS), Brief Fatigue Inventory (BFI), and the Short Form (SF-36). A total of 62 patients were included (n = 51 female, mean age 61 (SD 13) years). According to HADS, the prevalence of anxiety was 45% in the postoperative and 42% in the wait-and-watch group (p = 0.60), and depression was 61% and 87%, respectively (p = 0.005). In total, 43% of patients under wait-and-watch and 37% of patients in the postoperative group scored ≥6 on the DT scale. SF-36 scores were similar in all categories except general health (p = 0.005) and physical component aggregate score (43.7 (13.6) vs. 50.5 (9.5), (p = 0.03), both lower in the wait-and-watch group. Multivariate analysis revealed the wait-and-watch strategy was associated with a 4.26-fold higher risk of a pathological depression score based on HADS (p = 0.03). This study demonstrates a high prevalence of psychological distress in meningioma patients. Further evaluation is necessary to identify the patients in need of psychooncological support.
Highlights
Meningiomas are among the most commonly diagnosed primary central nervous system tumors, accounting for approximately one-third of all such cases [1]
This study demonstrates a high prevalence of psychological distress in meningioma patients
More than 90% of patients assessed had an Eastern Cooperative Oncology Group Performance Status (ECOG) 0 or 1 in both groups
Summary
Meningiomas are among the most commonly diagnosed primary central nervous system tumors, accounting for approximately one-third of all such cases [1]. They are usually benign and slow growing lesions, more often diagnosed in elderly patients and women [2]. Due to the increasing availability of diagnostic imaging, the number of patients with meningiomas as an incidental finding has increased. The majority of such neoplasms demonstrate only minimal growth; a wait-and-watch or conservative strategy can be undertaken until the lesion is significantly larger or becomes symptomatic [5]. The consultation of meningioma patients harboring incidental meningiomas regarding surgery or the wait-and-watch strategy is challenging and requires sensitive skills
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