Heterogeneous trajectory of cancer-related fatigue and its associated factors in patients with glioma during the perioperative period: a prospective longitudinal study.

PURPOSE: Fatigue is the most severe symptom of glioma and constitutes an adverse prognostic factor for patient survival. This study explored the potential categories and influencing factors of the change trajectory of cancer-related fatigue (CRF) in patients with gliomas during the perioperative period.

METHODS

Overall, 193 patients who underwent glioma resection in two tertiary general hospitals in Guangzhou from 1 December 2023 to 1 January 2025 were included. Data on social demographics, disease characteristics, psychological resilience, neuroticism, and perceived social support levels were collected. CRF was assessed 1 day preoperatively and 3, 7, 14, and 30 days postoperatively. A latent growth mixture model was used to identify potential categories of the change trajectory of CRF, and a disordered multinomial logistic regression analysis was used to explore influencing factors.

RESULTS

Overall, 161 patients with glioma were included. Potential CRF categories were 'low fatigue decreased' (71.4%), 'moderate fatigue increased' (17.4%), and 'persistently high fatigue' (11.2%). Logistic regression analysis revealed that patients with pathological grades III-IV (odds ratio [OR] = 2.71, P = 0.035), lower perceived social support (OR = 0.955, P = 0.033), and longer hospital stay (OR = 1.071, P = 0.006) were more likely to be classified into the 'moderate fatigue increased' group. In contrast, patients with pathological grades III-IV (OR = 5.78, P = 0.007) and lower resilience (OR = 0.935, P = 0.001) were more likely to be assigned to the 'persistently high fatigue' group.

CONCLUSION

'Low fatigue decreased', 'moderate fatigue increased', and 'persistently high fatigue' are potential CRF categories in patients with glioma during the perioperative period. Pathological stage, perceived social support, length of hospital stay, and resilience influence these patterns. Early screening for high-risk patients and individualised, full-course interventions are essential to reduce CRF burden during the perioperative period.