Dynamics in cognition and health-related quality of life in grade 2 and 3 gliomas after surgery

• DOI: 10.1007/s00701-022-05408-2
• Publication Date: 2022-11-04T16:03:44Z
• Authors: Teodor Svedung We...; Åsa A. Munkhammar; Malin Jemstedt; Marcus Ersson; Francesco Latini; Mats Ryttlefors; Maria Zetterling
• Keywords: Neurologi; Original Article - Brain Tumors; Brain Neoplasms; Health-related quality of life; Low-grade glioma; Oligodendroglioma; Glioma; Astrocytoma; Neuropsychological Tests; 3. Good health; Brain tumor; 03 medical and health sciences; Cognition; 0302 clinical medicine; Neurology; Quality of Life; Humans; Neoplasm Recurrence, Local; Cognition Disorders

Abstract

Background The focus of clinical management and research in gliomas has been on survival, but the interest in the treatment effects on cognition and health-related quality of life (HRQoL) is emerging. The primary aim of this study was to investigate the dynamics in cognition after brain tumor surgery for astrocytomas and oligodendrogliomas grade 2 and 3. The secondary aim was to investigate the association of postoperative changes in cognition with changes HRQoL.

Methods In this observational study, 48 patients operated for an astrocytoma or oligodendrogliomas, grade 2 or 3, at the Department of Neurosurgery, Uppsala, Sweden, 2016–2021, were included. Cognitive and language skills were assessed with a selected test battery and HRQoL was patient-reported as assessed with RAND-36 pre- and approximately 3 months postoperatively.

Results There was a significant postoperative decrease in attention span and verbal learning, but the patients improved in the test for visual memory. There was no change in visual attention, executive function, verbal memory, visual organization and construction, verbal fluency, and confrontation naming. The RAND-36 variables physical function, role physical, general health, vitality, and social functioning decreased significantly after surgery. Patients operated for tumor recurrence exhibited greater deterioration in attention and a greater extent of resection correlated with a less pronounced decrease in verbal memory, but there were otherwise weak associations between the dynamics in cognition and patient-, tumor-, and treatment-variables. A decline in cognitive variables was not associated with worse HRQoL.

Conclusions Although both several cognitive and HRQoL domains deteriorated postoperatively, these changes did not correlate with each other. This highlights the complexity of cognitive and HRQoL dynamics in the early postoperative phase.