Pretreatment patient-reported cognitive function in patients with diffuse glioma

Stine Schei; Ole Solheim; Øyvind Salvesen; Marianne Jensen Hjermstad; David Bouget; Lisa Millgård Sagberg

doi:10.1007/s00701-022-05126-9

Pretreatment patient-reported cognitive function in patients with diffuse glioma

Acta Neurochir (Wien). 2022 Mar;164(3):703-711. doi: 10.1007/s00701-022-05126-9. Epub 2022 Feb 10.

Authors

Stine Schei^{1

2}, Ole Solheim^{3

4}, Øyvind Salvesen⁵, Marianne Jensen Hjermstad^{6

7

8}, David Bouget⁹, Lisa Millgård Sagberg^{10

4}

Affiliations

¹ Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway. stine.schei@ntnu.no.
² Department of Neurology, St. Olavs hospital, Trondheim, Norway. stine.schei@ntnu.no.
³ Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.
⁴ Department of Neurosurgery, St. Olavs hospital, Trondheim, Norway.
⁵ Unit for Applied Clinical Research, Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
⁶ Regional Advisory Unit in Palliative Care, Department of Oncology, Oslo University Hospital, Oslo, Norway.
⁷ European Palliative Care Research Centre, Department of Oncology, Oslo University Hospital, Oslo, Norway.
⁸ Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
⁹ Department of Health Research, SINTEF Digital, Trondheim, Norway.
¹⁰ Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway.

Abstract

Purpose: Cognitive function is frequently assessed with objective neuropsychological tests, but patient-reported cognitive function is less explored. We aimed to investigate the preoperative prevalence of patient-reported cognitive impairment in patients with diffuse glioma compared to a matched reference group and explore associated factors.

Methods: We included 237 patients with diffuse glioma and 474 age- and gender-matched controls from the general population. Patient-reported cognitive function was measured using the cognitive function subscale in the European Organisation for Research and Treatment of Cancer QLQ-C30 questionnaire. The transformed scale score (0-100) was dichotomized, with a score of ≤ 75 indicating clinically important patient-reported cognitive impairment. Factors associated with preoperative patient-reported cognitive impairment were explored in a multivariable regression analysis.

Results: Cognitive impairment was reported by 49.8% of the diffuse glioma patients and by 23.4% in the age- and gender-matched reference group (p < 0.001). Patients with diffuse glioma had 3.2 times higher odds (95% CI 2.29, 4.58, p < 0.001) for patient-reported cognitive impairment compared to the matched reference group. In the multivariable analysis, large tumor volume, left tumor lateralization, and low Karnofsky Performance Status score were found to be independent predictors for preoperative patient-reported cognitive impairment.

Conclusions: Our findings demonstrate that patient-reported cognitive impairment is a common symptom in patients with diffuse glioma pretreatment, especially in patients with large tumor volumes, left tumor lateralization, and low functional levels. Patient-reported cognitive function may provide important information about patients' subjective cognitive health and disease status and may serve as a complement to or as a screening variable for subsequent objective testing.

Keywords: Brain neoplasms; Cognition; Glioma; Patient-reported outcome measures; Preoperative period.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Brain Neoplasms* / complications
Brain Neoplasms* / psychology
Brain Neoplasms* / surgery
Cognition
Cognitive Dysfunction* / complications
Cognitive Dysfunction* / etiology
Glioma* / complications
Glioma* / epidemiology
Glioma* / surgery
Humans
Patient Reported Outcome Measures
Quality of Life