gms | German Medical Science

Objective: Intracranial meningioma WHO grade I is considered a benign disease with long-term disease control after extensive surgery. However, the psychooncological burden of these patients is still poorly defined. Here, we sought to analyse health-related quality of life (QoL) after meningioma resection.

Methods: We performed a retrospective cross-sectional analysis of health-related QoL in our institutional cohort of patients with surgery as the first intervention for intracranial meningioma. Standardized self-assessment questionnaires (HADS-D, EORTC-QLQ-C30) were sent out by mail after written informed content. Results were correlated with demographic, tumour- and treatment-related factors by univariate und multivariate linear regression and were compared to normative data derived from the general German population. Time-dependent effects of QoL data were assessed by Spearman correlation.

Results: Out of 653 patients addressed, 327 patients with intracranial meningioma WHO grade I returned the questionnaires. 81% were female, median age at diagnosis was 56 years and skull base and other tumour locations were evenly distributed (53% vs. 47%). Extent of resection was Simpson grade 1-3 in 86% and 4% underwent postoperative radiotherapy. Recurrence occurred in 17% after a median follow-up of 38 months. Health related QoL was assessed at a median interval of 31 months after last intervention. 34% and 24% of patients were screened positive on the anxiety and depression subscales of HADS-D as opposed to 21% and 24% of the general population. Compared to normative data, patients reported impaired QoL based on all function and symptom scales of EORTC-QLQ-C30. Noteworthy, both HADS-D and QLQ-C30 scores improved significantly in a time-dependent manner and levelled with the general population 5 years after last intervention. For the majority of QLQ-C30 subscales, female sex, residual disease (Simpson grade 4-5) and tumour recurrence were identified as independent predictors of impaired QoL.

Conclusion: Despite the supposedly benign nature of this disease, QoL of meningioma WHO grade I patients was impaired compared to the general population but improved significantly with increasing distance from the last intervention, indicating that the need for psychooncological intervention is highest in the first years after index surgery. Independent predictive factors of impaired QoL identified in this cohort can only in part be modified by tumour treatment.