gms | German Medical Science

Objective: The impact of open resection for primary and recurrent glioblastoma (pGBM and rGBM) on quality of life (QoL) is still unclear. The aim of this work is to evaluate the impact of surgery on QoL in adult patients with pGBM and rGBM seen consecutively in our neurooncological routine practice.

Method: Inclusion criteria for this single centre, prospective study were: surgical resection of GBM at first diagnosis followed by standard adjuvant radio-chemotherapy and surgical resection at first recurrence. For primary and recurrent surgery, pre-operative, post-operative and 3 months evaluation of QoL using the EORTC questionnaire (QLQ-C30) and QLQ-Brain Cancer Modules (QLQ-BN20) was determined. Results are divided into: Functional Scores, Global Heath Status, QoL Status and Symptom Scale. At the same time points, we collected the NIHSS as well.

Results: In this single center observation study for primary surgery, 36 pre-operative, 30 early post-operative and 42 QoL questionnaires 3 months after surgery were available. Concerning the period of the first recurrence, we collected 23 pre-operative, 22 post-operative and 14 QoL questionnaires 3 months after surgery. NIHS Scores were available at all time points. Median Functional Score was 50.0 for first surgery and 45.2 for recurrent surgery at the pre-operative evaluation, 75.5 and 43.3 at the post-operative one, 28.8 and 33.3 3 months after the operation. Median Global Health Status was 50.0 for first surgery and 50.0 for recurrent surgery at the pre-operative evaluation, 33.3 and 58.3 at the post-operative one, 33.3 and 33.3 3 months after the operation. Median QoL Status was 66.5 for first surgery and 50.0 for recurrent surgery at the pre-operative evaluation, 50.0 and 58.3 at the post-operative one, 25.0 and 50.0 3 months after the operation. Median Symptom Scale Score was 10.2 for first surgery and 23.0 for recurrent surgery at the pre-operative evaluation, 20.5 and 47.1 at the post-operative one, 30.7 and 47.9 3 months after the operation. Median NIHSS was 0 for first surgery and 1 for recurrent surgery at the pre-operative evaluation, 1 and 2 at the post-operative one, 0 and 1 3 months after the operation.

Conclusions: Our study shows that, despite only minor changes within the NIHSS, QoL evaluations elicit increased subjective symptom burden in the recurrent setting. We therefore recommend that more efforts should be invested in psycho-oncological screening and psychological treatment options in this population.