Article
Assessment of psychological distress in meningioma patients under watchful waiting and after complete resection
Beurteilung der psychischen Belastung in Patienten mit Meningeom unter Beobachtung und nach einer kompletten Resektion
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Authors
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Darius Kalasauskas
- University Medical Centre, Johannes Gutenberg University Mainz, Department of Neurosurgery, Mainz, Deutschland
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Naureen Keric
- University Medical Centre, Johannes Gutenberg University Mainz, Department of Neurosurgery, Mainz, Deutschland
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Leoni von Cube
- University Medical Centre, Johannes Gutenberg University Mainz, Department of Neurosurgery, Mainz, Deutschland
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Salman Abu Ajaj
- University Medical Centre, Johannes Gutenberg University Mainz, Department of Neurosurgery, Mainz, Deutschland
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Florian Ringel
- University Medical Centre, Johannes Gutenberg University Mainz, Department of Neurosurgery, Mainz, Deutschland
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Mirjam Renovanz
- University Medical Centre, Johannes Gutenberg University Mainz, Department of Neurosurgery, Mainz, Deutschland; University Hospital Tübingen, Department of Neurosurgery, Tübingen, Deutschland; University Hospital Tübingen, Department of Neurology & Interdisciplinary Neuro-Oncology, Tübingen, Deutschland
| Published: | June 4, 2021 |
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Outline
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Objective: Asymptomatic meningiomas can be found in 1-2% of cranial MRIs. Due to increasing availability of cranial MRI, the number of patients being managed with follow-up imaging and at the same time facing a diagnosis of a brain tumor is rising. The aim of this study was comparing the psychosocial burden of meningioma patients under wait-and-watch strategy and in patients with an uneventful complete resection.
Methods: In our prospective study in a single tertiary neurosurgical center we included patients with either 1) an incidental meningioma under a watchful waiting (WW) strategy or 2) no neurologic deficits after complete resection (postoperative - PO). Sociodemographic, clinical, and health-related quality of life and clinical data were assessed, inter alia by the ECOG and Neurologic Assessment in Neuro-Oncology (NANO) scale. 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). Student’s t, Mann-Whitney, Chi-squared tests, Spearman’s rho, logistic regression were used as appropriate. P<0.05 was considered as statistically significant.
Results: In total, 62 patients were included into the study (31 patients each group, n = 51 female, mean age 61, SD=13 years). We found a high prevalence of depression (61% (n=19) in PO and 87% (n=27) in WW group) and anxiety (45% and 42%, respectively). 43% of patients under WW and 37% of PO patients reported significant distress (≥6) on DT scale, 45% patients under WW and 58% PO patients reported significant fatigue. Mean SF-36 values were lower in WW group; however, it was statistically significant only for General Health subscale and Physical Health Component. There was no significant difference between the groups according to objective ECOG and NANO assessments (mean NANO score 0.4 (SD 0.8) vs. 0.5 (SD 1.0). There was no correlation between HADS and DT scores and time since surgery or tumor diagnosis. WW was associated with higher prevalence of depression (odds ratio 4.26 (95% CI: 1.19–15.25).
Conclusion: Meningioma patients suffer from high prevalence of psychological distress, independent from the management strategy and the time since the diagnosis. In our patient sample, WW strategy was associated with a higher burden than uneventful tumor resection, indicating that frequent assessment is necessary also in patients under WW to identify the patients in need of psychooncological support.
