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XXI Congreso Nacional de la Sociedad Española de Neurocirugía
Barcelona, 17-19 May 2017
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R. Fernández Méndez, W.A. Sage, R.J. Rastall, Y. Wan, S.J. Price and A.J. Joannides

University of Cambridge, Cambridge, United Kingdom.

Objectives: Surgical intervention is a key component of initial treatment for brain tumours, and its potential benefit must be outweighed against any adverse patient impact it may have. The importance of health-related quality-of-life (QoL) on informing management decisions is increasingly recognised, and we have recently established routine QoL measurement across the neuro-oncology patient pathway. On this background, we sought to evaluate the short-term impact of brain tumour surgery on QoL.

Methods: Patients presenting to a single centre were asked to complete a well-validated brain cancer QoL questionnaire (EORTC QLQ-C30 with BN20 module). Patients with a completed baseline and post-operative questionnaire within 3 months of surgery were included. The Wilcoxon signed-rank test was used to compare pre-operative and post-operative values in global health domains and cancer-related symptoms.

Results: A total of 29 patients were included in the analysis (16 female; 13 male; median [IQR] 56 [49-64] years). Most patients had high grade glioma (15; 52%) with smaller numbers of patients having low-grade glioma, metastatic tumours and meningioma. The majority of patients underwent resective surgery (22; 76%) and the remainder a biopsy only. Median time between initial questionnaire and surgery was 15 days and between surgery and follow-up questionnaire 9 days. Global functioning showed no significant difference between the two assessments (p = 0.341), whilst physical function (p = 0.001) and role functioning (p = 0.042) deteriorated. Symptom scores were largely unchanged post-operatively, except for pain (p < 0.001) and headache (p = 0.003), which increased, and future uncertainty (p = 0.035), which decreased.

Conclusions: Following establishment of longitudinal assessment of QoL in a routine neuro-oncology service setting, our preliminary results suggest that there is no short-term deterioration of global QoL following surgical intervention despite reduced physical and role functioning. This establishes an additional dimension for evaluating surgical impact, and guiding subsequent patient management.

Neurocirugía (English edition)

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