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67th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Korean Neurosurgical Society (KNS)

German Society of Neurosurgery (DGNC)

12 - 15 June 2016, Frankfurt am Main

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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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  • Bernd-Otto Hütter - Neurochirurgische Klinik, Universitätsklinikum Essen, Germany
  • Karsten H. Wrede - Neurochirurgische Klinik, Universitätsklinikum Essen, Germany
  • Nicolai El Hindy - Neurochirurgische Klinik, Universitätsklinikum Essen, Germany
  • Anne-Kathrin Uerschels - Neurochirurgische Klinik, Universitätsklinikum Essen, Germany
  • Oliver Müller - Neurochirurgische Klinik, Universitätsklinikum Essen, Germany
  • Ulrich Sure - Neurochirurgische Klinik, Universitätsklinikum Essen, Germany

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocMO.04.01

doi: 10.3205/16dgnc015, urn:nbn:de:0183-16dgnc0152

Published: June 8, 2016

© 2016 Hütter et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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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.