Details

Autor(en) / Beteiligte

• Jakola, Asgeir S
• Unsgård, Geirmund
• Myrmel, Kristin S
• Kloster, Roar
• Torp, Sverre H
• Sagberg, Lisa M
• Lindal, Sigurd
• Solheim, Ole

Titel

Surgical strategies in low-grade gliomas and implications for long-term quality of life

Ist Teil von

• Journal of clinical neuroscience, 2014-08, Vol.21 (8), p.1304-1309

Ort / Verlag

Scotland: Elsevier Ltd

Erscheinungsjahr

2014

Quelle

Access via ScienceDirect (Elsevier)

Beschreibungen/Notizen

• Abstract Reports on long-term health related quality of life (HRQL) after surgery for World Health Organization grade II diffuse low-grade gliomas (LGG) are rare. We aimed to compare long-term HRQL in two hospital cohorts with different surgical strategies. Biopsy and watchful waiting was favored in one hospital, while early resections guided with three-dimensional (3D) ultrasound was favored in the other. With a population-based approach 153 patients with histologically verified LGG treated from 1998–2009 were included. Patients still alive were contacted for HRQL assessment (n = 91) using generic (EQ-5D; EuroQol Group, Rotterdam, The Netherlands) and disease specific (EORTC QLQ-C30 and BN20; EORTC Quality of Life Department, Brussels, Belgium) questionnaires. Results on HRQL were available in 79 patients (87%), 25 from the hospital that favored biopsy and 54 from the hospital that favored early resection. Among living patients there was no difference in EQ-5D index scores ( p = 0.426). When imputing scores defined as death (zero) in patients dead at follow-up, a clinically relevant difference in EQ-5D score was observed in favor of early resections ( p = 0.022, mean difference 0.16, 95% confidence interval 0.02–0.29). In EORTC questionnaires pain, depression and concern about disruption in family life were more common with a strategy of initial biopsy only ( p = 0.043, p = 0.032 and p = 0.045 respectively). In long-term survivors an aggressive surgical approach using intraoperative 3D ultrasound image guidance in LGG does not lower HRQL compared to a more conservative surgical approach. This finding further weakens a possible role for watchful waiting in LGG.