Article
The psycho-oncological burden of patients with aggressive meningioma – results from a retrospective cross-sectional study
Die psychoonkologische Belastung von Patienten mit aggressiven Meningeomen – Ergebnisse einer retrospektiven Querschnittstudie
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Authors
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Christine Jungk
- Ruprecht-Karls-University Heidelberg, Department of Neurosurgery, Heidelberg, Deutschland
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Madlen Rädel
- Ruprecht-Karls-University Heidelberg, Department of Neurosurgery, Heidelberg, Deutschland
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Julia Mattern-Tremper
- Ruprecht-Karls-University Heidelberg, Department of Neurosurgery, Heidelberg, Deutschland
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Christel Herold-Mende
- Ruprecht-Karls-University Heidelberg, Department of Neurosurgery, Heidelberg, Deutschland
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Andreas W. Unterberg
- Ruprecht-Karls-University Heidelberg, Department of Neurosurgery, Heidelberg, Deutschland
| Published: | June 4, 2021 |
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Outline
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Objective: Despite the overall perception of meningioma as a benign disease, 20-35% of patients experience a clinically aggressive course with debilitating treatment and poor outcome. In contrast to the growing interest in novel therapeutic strategies, the impact on health-related quality of life (QoL) is still understudied. Here, we analysed the psycho-oncological burden of patients with aggressive meningioma.
Methods: Our institutional cohort was searched for patients with surgery as the first intervention for intracranial meningioma and health-related QoL was assessed retrospectively at one time point with standardized self-assessment questionnaires (HADS-D, EORTC-QLQ-C30). Aggressive meningioma was defined as WHO grade II or III histology or recurrence of a WHO grade I meningioma within 5 years after index surgery. Results were correlated with demographic, tumour- and treatment-related factors by univariate und multivariate linear regression and were compared to internal control patients (WHO grade I meningioma, no recurrence within the first 5 years).
Results: 400 out of 653 meningioma patients addressed returned the questionnaires (62%). Of those, 95 patients (24%) were classified as aggressive meningioma (recurrent WHO grade I: n=45; WHO grade II: n=49; WHO grade III: n=1) while 305 patients served as internal control. Patients with and without aggressive meningioma differed with regard to sex (p=0.019), age (p=0.015), extent of resection (p<0.0001) and adjuvant radiotherapy (p<0.0001) at index surgery and KPS at 1st follow-up (p=0.037). 34% and 24% of aggressive meningioma patients were screened positive on the anxiety and depression subscales of HADS-D as opposed to 33% and 27% of internal controls (not significant). Aggressive meningioma patients fared significantly worse on most of the function scales of QLQ-C30 (QL: p=0.004; PF: p=0.049; RF: p=0.003; CF: p=0.01; SF: p=0.018) and reported more financial difficulties (FI: p=0.015). In multivariate regression analysis of the complete cohort, female sex, KPS at 1st follow-up <70 and aggressive meningioma were independent factors of impaired QoL.
Conclusion: In this cross-sectional analysis, QoL was significantly impaired in aggressive meningioma patients, in line with a higher treatment intensity and lower postoperative functional status. Knowing that, patients with aggressive meningioma should be screened and treated for their psycho-oncological needs and QoL should be assessed longitudinally.
