Heterogeneity in quality-of-life of patients before and after brain tumour surgery

Abstract

OBJECTIVES: Measurement of health-related quality of life (QoL) in brain tumour patients is increasingly recognised as a means of informing treatment decisions. On this background, we assessed the shortterm impact of surgery on QoL across 2 UK neuroscience centres. METHODS: Patients with a brain tumour were asked to complete the EORTC QLQ-30 with BN20 module at initial assessment and in their first postoperative appointment within 3 months of surgery. Wilcoxon rank sum and Wilcoxon signed rank tests were used to compare baseline scores between centres, and post-operative changes within patients respectively. RESULTS: A total of 57 patients were included in the analysis. There were comparable numbers from each site (29 and 28 respectively), with no significant differences between baseline demographics and tumour types between them. Time between completing the baseline questionnaire and surgery was similar, but the time from surgery to follow-up questionnaire differed between the sites (median[IQR]: 9[6-10] vs. 16[9-35], p=0.024). Baseline scores for global health status and the functional domains were similar across the sites, but significant differences were noted in symptom scores, including pain, communication deficit, headaches, itchy skin and hair loss. Post-operatively, there was no deterioration in global health status despite changes in other symptom scales. In both sites, there was a post-operative deterioration in physical and role functioning. In one site, there was deterioration in pain and headache but improvement in future uncertainty, while in the other there was a deterioration in social functioning but improvement in emotional functioning and nausea and vomiting. CONCLUSIONS: There is considerable variation in the QoL of neuro-oncology patients, both in baseline scores at initial diagnosis, as well as change in individual domains following surgery. This highlights the importance of measuring baseline and follow-up QoL dimensions as a means of enabling a bespoke care approach tailored to individual patient need.