Effects of surgical resection on the evolution of quality of life in newly diagnosed patients with glioblastoma: a report on 19 patients surviving to follow-up.

OBJECTIVE

Although aggressive tumor resection favors survival in neuro-oncology, its effects on quality of life (QOL) are largely unspecified. The objective of the present study, therefore, was to study the relationship between tumor resection and QOL.

METHODS

We conducted a longitudinal study among 35 patients presenting with a suspected, and later confirmed, glioblastoma multiforme tumor. Following surgery, all patients received radiation therapy with concomitant temozolomide. Tumor volumes were segmented manually, and extent of resection was calculated by comparing pre- and post-operative volumes. QOL was obtained at intake and 3 months later, using the Sherbrooke Neuro-Oncology Assessment Scale. Change in QOL was determined by computing the difference between intake and follow-up data. Confounds were controlled for by detrending change in QOL scores from the effects of age, initial tumor volume, tumor location, and baseline QOL.

RESULTS

Results showed that larger tumors at intake provoke increased pain (mostly headaches; r = 0.41, p = 0.015) and decreased social support/acceptance of disease (r = 0.43, p = 0.009). Results also showed that compared to biopsies, craniotomies were associated with preserved well-being across nearly all domains of QOL. When extent of resection was analyzed more specifically, results confirmed that larger resections prevented the decay in functional well-being (r = 0.616, p = 0.005) and neurocognitive function (r = 0.51, p = 0.026) typically observed as time progresses. Larger resections were also independently associated with prolonged survival.

CONCLUSIONS

Although the data were obtained from a relatively small sample of patients, results indicate that aggressive resections avert decay in QOL, and thus prolong optimized survival.