Artikel
Time course of cognition and health-related quality of life in patients undergoing surgery for supratentorial meningiomas: First results of a prospective long-term study
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Veröffentlicht: | 8. Juni 2016 |
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Gliederung
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Objective: Meningiomas are amongst the most frequent brain tumors, constituting approximately 35% of all intracranial neoplasms. After complete lesion removal 10-year survival rate is about 95%. Therefore, preservation of cognitive function and health-related quality of life (HRQOL) is of core interest in these patients. Thus, the present study was performed to analyze pre- and postoperative changes in cognition and HRQOL in patients operated upon a supratentorial meningioma.
Method: Up to the present, a consecutive series of 35 patients was investigated for their HRQOL and cognitive capacity. The study group comprised 11 male (31%) and 24 female (69%) patients with a mean age of 53.7 years (SD 11.2; range 18 - 70 years) Cognition was assessed by means of a comprehensive neuropsychological testing battery including tests for language, short- and long-term memory and different aspects of attention. The Aachen Life Quality Inventory (ALQI) was used for HRQOL assessment. Tumor diameter was measured by automatized MR-algorithms.
Results: The results of cognitive testing and HRQOL of 29 patients were available for pre- and postoperative analysis. A significantly better performance was observed postoperatively only in the Go/NoGo task and in verbal short-term memory (p<.05, respectively). No significant differences in test means were found between left and right-sided tumor location. On the other hand, single-case analysis revealed that left hemispheric processes were associated with a significantly higher frequency of cognitive deficits beyond language-bound functions. Tumor diameter correlated with r= .25 (p<.05; Spearman rank-order) with the frequency of new postoperative deficits, but exhibited no substantial association with preoperative deficits. According to statistical single-case analysis 6 (21%) patients worsened substantially postoperatively (one of them developed a new aphasia) while 13 (45%) patients improved significantly. The other patients remained stable.
Conclusions: About half (45%) of the patients improved substantially after microneurosurgical resection of a supratentorial meningioma. A further third (34%) remained stable after surgery. Patients with postoperative cognitive deterioration presented with large tumors and/or suffered damage to vascular structures including venous drainage.