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Frances SM, Murray L, Nicklin E, Velikova G, Boele F. Long-term health-related quality of life in meningioma survivors: A mixed-methods systematic review. Neurooncol Adv 2024; 6:vdae007. [PMID: 38375359 PMCID: PMC10876080 DOI: 10.1093/noajnl/vdae007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024] Open
Abstract
Background Meningiomas account for ~25% of all primary brain tumors. These tumors have a relatively favorable prognosis with ~92% of meningioma patients surviving >5 years after diagnosis. Yet, patients can report high disease burden and survivorship issues even years after treatment, affecting health-related quality of life (HRQOL). We aimed to systematically review the literature and synthesize evidence on HRQOL in meningioma patients across long-term survival, defined as ≥2 years post-diagnosis. Methods Systematic literature searches were carried out using Medline, EMBASE, CINAHL, PsycINFO, and Web of Science Core Collection. Any published, peer-reviewed articles with primary quantitative, qualitative, or mixed-methods data covering the physical, mental, and/or social aspects of HRQOL of meningioma survivors were included. A narrative synthesis method was used to interpret the findings. Results Searches returned 2253 unique publications, of which 21 were included. Of these, N = 15 involved quantitative methodology, N = 4 mixed methods, and N = 2 were qualitative reports. Patient sample survival ranged from 2.75 to 13 years. HRQOL impairment was seen across all domains. Physical issues included persevering symptoms (eg, headaches, fatigue, vision problems); mental issues comprised emotional burden (eg, high prevalence of depressive symptoms and anxiety) and cognitive complaints; social issues included role limitations, social isolation, and affected work productivity. Due to study heterogeneity, the impact of treatment on long-term HRQOL remains unclear. Conclusions The findings from this review highlight the areas of HRQOL that can be impacted in long-term survivorship for patients with meningioma. These findings could help raise awareness among clinicians and patients, facilitating support provision.
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Affiliation(s)
- Sé Maria Frances
- Patient-Centred Outcomes Research, Leeds Institute of Medical Research at St James’s, St James’s University Hospital, University of Leeds, Leeds, UK
| | - Louise Murray
- Department of Clinical Oncology, Leeds Cancer Centre, Leeds Institute of Medical Research at St James’s, University of Leeds, Leeds, UK
| | - Emma Nicklin
- Patient-Centred Outcomes Research, Leeds Institute of Medical Research at St James’s, St James’s University Hospital, University of Leeds, Leeds, UK
| | - Galina Velikova
- Patient-Centred Outcomes Research, Leeds Institute of Medical Research at St James’s, St James’s University Hospital, University of Leeds, Leeds, UK
- Department of Clinical Oncology, Leeds Cancer Centre, Leeds Institute of Medical Research at St James’s, University of Leeds, Leeds, UK
| | - Florien Boele
- Patient-Centred Outcomes Research, Leeds Institute of Medical Research at St James’s, St James’s University Hospital, University of Leeds, Leeds, UK
- Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
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Sleurs C, Zegers CML, Compter I, Dijkstra J, Anten MHME, Postma AA, Schijns OEMG, Hoeben A, Sitskoorn MM, De Baene W, De Roeck L, Sunaert S, Van Elmpt W, Lambrecht M, Eekers DBP. Neurocognition in adults with intracranial tumors: does location really matter? J Neurooncol 2022; 160:619-629. [PMID: 36346497 PMCID: PMC9758085 DOI: 10.1007/s11060-022-04181-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 10/22/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE As preservation of cognitive functioning increasingly becomes important in the light of ameliorated survival after intracranial tumor treatments, identification of eloquent brain areas would enable optimization of these treatments. METHODS This cohort study enrolled adult intracranial tumor patients who received neuropsychological assessments pre-irradiation, estimating processing speed, verbal fluency and memory. Anatomical magnetic resonance imaging scans were used for multivariate voxel-wise lesion-symptom predictions of the test scores (corrected for age, gender, educational level, histological subtype, surgery, and tumor volume). Potential effects of histological and molecular subtype and corresponding WHO grades on the risk of cognitive impairment were investigated using Chi square tests. P-values were adjusted for multiple comparisons (p < .001 and p < .05 for voxel- and cluster-level, resp.). RESULTS A cohort of 179 intracranial tumor patients was included [aged 19-85 years, median age (SD) = 58.46 (14.62), 50% females]. In this cohort, test-specific impairment was detected in 20-30% of patients. Higher WHO grade was associated with lower processing speed, cognitive flexibility and delayed memory in gliomas, while no acute surgery-effects were found. No grading, nor surgery effects were found in meningiomas. The voxel-wise analyses showed that tumor locations in left temporal areas and right temporo-parietal areas were related to verbal memory and processing speed, respectively. INTERPRETATION Patients with intracranial tumors affecting the left temporal areas and right temporo-parietal areas might specifically be vulnerable for lower verbal memory and processing speed. These specific patients at-risk might benefit from early-stage interventions. Furthermore, based on future validation studies, imaging-informed surgical and radiotherapy planning could further be improved.
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Affiliation(s)
- Charlotte Sleurs
- Department of Cognitive Neuropsychology, Tilburg University, Tilburg, The Netherlands.
- Department of Oncology, KU Leuven, Leuven, Belgium.
| | - Catharina M L Zegers
- Department of Radiation Oncology (Maastro), GROW School for Oncology and Reproduction, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Inge Compter
- Department of Radiation Oncology (Maastro), GROW School for Oncology and Reproduction, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Jeanette Dijkstra
- Department of Medical Psychology, Maastricht University Medical Center+, MHeNs School for Mental Health and Neuroscience, Maastricht, The Netherlands
| | - Monique H M E Anten
- Department of Neurology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Alida A Postma
- Department of Radiology & Nuclear Medicine, Maastricht University Medical Center+, MHeNs School for Mental Health and Neuroscience, Maastricht, The Netherlands
| | - Olaf E M G Schijns
- Department of Neurosurgery, Maastricht University Medical Center+, MHeNs School for Mental Health and Neuroscience, Maastricht, The Netherlands
| | - Ann Hoeben
- Division of Medical Oncology, Department of Internal Medicine, GROW-School of Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Margriet M Sitskoorn
- Department of Cognitive Neuropsychology, Tilburg University, Tilburg, The Netherlands
| | - Wouter De Baene
- Department of Cognitive Neuropsychology, Tilburg University, Tilburg, The Netherlands
| | | | - Stefan Sunaert
- Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Wouter Van Elmpt
- Department of Radiation Oncology (Maastro), GROW School for Oncology and Reproduction, Maastricht University Medical Center+, Maastricht, The Netherlands
| | | | - Daniëlle B P Eekers
- Department of Radiation Oncology (Maastro), GROW School for Oncology and Reproduction, Maastricht University Medical Center+, Maastricht, The Netherlands
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Wu S, Ballah AK, Che W, Wang X. M7G-related LncRNAs: A comprehensive analysis of the prognosis and immunity in glioma. Front Genet 2022; 13:961278. [DOI: 10.3389/fgene.2022.961278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 11/02/2022] [Indexed: 11/17/2022] Open
Abstract
Today, numerous international researchers have demonstrated that N7-methylguanosine (m7G) related long non-coding RNAs (m7G-related lncRNAs) are closely linked to the happenings and developments of various human beings’ cancers. However, the connection between m7G-related lncRNAs and glioma prognosis has not been investigated. We did this study to look for new potential biomarkers and construct an m7G-related lncRNA prognostic signature for glioma. We identified those lncRNAs associated with DEGs from glioma tissue sequences as m7G-related lncRNAs. First, we used Pearson’s correlation analysis to identify 28 DEGs by glioma and normal brain tissue gene sequences and predicated 657 m7G-related lncRNAs. Then, eight lncRNAs associated with prognosis were obtained and used to construct the m7G risk score model by lasso and Cox regression analysis methods. Furthermore, we used Kaplan-Meier analysis, time-dependent ROC, principal component analysis, clinical variables, independent prognostic analysis, nomograms, calibration curves, and expression levels of lncRNAs to determine the model’s accuracy. Importantly, we validated the model with external and internal validation methods and found it has strong predictive power. Finally, we performed functional enrichment analysis (GSEA, aaGSEA enrichment analyses) and analyzed immune checkpoints, associated pathways, and drug sensitivity based on predictors. In conclusion, we successfully constructed the formula of m7G-related lncRNAs with powerful predictive functions. Our study provides instructional value for analyzing glioma pathogenesis and offers potential research targets for glioma treatment and scientific research.
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The need to consider return to work as a main outcome in patients undergoing surgery for diffuse low-grade glioma: a systematic review. Acta Neurochir (Wien) 2022; 164:2789-2809. [PMID: 35945356 DOI: 10.1007/s00701-022-05339-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 08/02/2022] [Indexed: 01/26/2023]
Abstract
OBJECTIVE For a long time, return to work (RTW) has been neglected in patients harboring a diffuse low-grade glioma (LGG). However, a majority of LGG patients worked at time of diagnosis. Moreover, these patients now live longer given current treatment paradigms, especially thanks to early maximal surgery. METHODS We systematically searched available medical databases for studies that reported data on RTW in patients who underwent resection for LGG. RESULTS A total of 30 studies were selected: 19 considered RTW (especially rate and timing) as an outcome and 11 used scales of health-related quality of life (HRQoL) which included work-related aspects. Series that considered RTW as a main endpoint were composed of 1014 patients, with postoperative RTW rates ranging from 31 to 97.1% (mean 73.1%). Timing to RTW ranged from 15 days to 22 months (mean 6.3 months). Factors related to an increased proportion of RTW were: younger age, better neurologic status, having a white-collar occupation, working pre-operatively, being the sole breadwinner, the use of awake surgery, and greater extent of resection. Female sex, older age, poor neurologic status, pre-operative history of work absences, slow lexical access speed, and postoperative seizures were negatively related to RTW. No studies that used HRQoL scales directly investigated RTW rate or timing. CONCLUSIONS RTW was scarcely analyzed in LGG patients who underwent resection. However, because they are usually young, with no or only mild functional deficits and have a longer life expectancy, postoperative RTW should be assessed more systematically and accurately as a main outcome. As majority (61.5-100%) of LGG patients were working at time of surgery, the responsibility of neurosurgeons is to bring these patients back to their previous activities according to his/her wishes. RTW might also be included as a critical endpoint for future prospective studies and randomized control trials on LGGs.
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Boele FW, den Otter PWM, Reijneveld JC, de Witt Hamer PC, van Thuijl HF, Lorenz LMC, Wesseling P, Lagerwaard FJ, Taphoorn MJB, Kouwenhoven MCM, Snijders TJ, Douw L, Klein M. Long-term wellbeing and neurocognitive functioning of diffuse low-grade glioma patients and their caregivers: A longitudinal study spanning two decades. Neuro Oncol 2022; 25:351-364. [PMID: 35908832 PMCID: PMC9925694 DOI: 10.1093/neuonc/noac185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND While patients with diffuse low-grade glioma (LGG) often survive for years, there is a risk of tumor progression which may impact patients' long-term health-related quality of life (HRQOL) and neurocognitive functioning (NCF). We present a follow-up of LGG patients and their informal caregivers (T3) who took part in our previous HRQOL investigations (T1, M = 7 and T2 M = 13 years after diagnosis). METHODS Participants completed HRQOL (short form-36 health survey [SF-36]; EORTC-BN20), fatigue (Checklist Individual Strength [CIS]), and depression (Center for Epidemiological Studies-Depression [CES-D]) questionnaires and underwent NCF assessments. T3 scores were compared with matched controls. Changes over time (T1-T2-T3) on group and participant level were assessed. Where available, histology of the initial tumor was revised and immunohistochemical staining for IDH1 R132H mutant protein was performed. RESULTS Thirty patients and nineteen caregivers participated. Of N = 11 with tissue available, 3 patients had confirmed diffuse LGG. At T3, patients (M = 26 years after diagnosis) had HRQOL and NCF similar to, or better than controls, yet 23.3% and 53.3% scored above the cut-off for depression (≥16 CES-D) and fatigue (≥35 CIS), respectively. Caregivers' HRQOL was similar to controls but reported high rates of fatigue (63.2%). Over time, patients' mental health improved (P < .05). Minimal detectable change in HRQOL over time was observed in individual patients (30% improvement; 23.3% decline; 20% both improvement and decline) with 23.3% remaining stable. NCF remained stable or improved in 82.8% of patients. CONCLUSIONS While HRQOL and NCF do not appear greatly impacted during long-term survivorship in LGG, depressive symptoms and fatigue are persistent.
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Affiliation(s)
- Florien W Boele
- Leeds Institute of Medical Research at St James’s, St James’s University Hospital, University of Leeds, Leeds, UK,Leeds Institute of Health Sciences, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Patricia W M den Otter
- Department of Medical Psychology, Cancer Center Amsterdam, Brain Tumor Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Jaap C Reijneveld
- Department of Neurology, SEIN, Heemstede, the Netherlands,Department of Neurology, Cancer Center Amsterdam, Brain Tumor Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands
| | - Philip C de Witt Hamer
- Department of Neurosurgery, Cancer Center Amsterdam, Brain Tumor Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Hinke F van Thuijl
- Department of Neurology, SEIN, Heemstede, the Netherlands,Department of Neurology, Cancer Center Amsterdam, Brain Tumor Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands
| | - Linda M C Lorenz
- Department of Medical Psychology, Cancer Center Amsterdam, Brain Tumor Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Pieter Wesseling
- Department of Pathology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands,Laboratory for Childhood Cancer Pathology, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Frank J Lagerwaard
- Department of Radiation Oncology, Cancer Center Amsterdam, Brain Tumor Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Martin J B Taphoorn
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands,Department of Neurology, Haaglanden Medical Center, The Hague, the Netherlands
| | - Mathilde C M Kouwenhoven
- Department of Neurology, Cancer Center Amsterdam, Brain Tumor Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands
| | - Tom J Snijders
- UMC Utrecht Brain Center, Department of Neurology and Neurosurgery, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Linda Douw
- Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Martin Klein
- Corresponding Author: Martin Klein, PhD, Department of Medical Psychology, Amsterdam UMC, location Vrije Universiteit Amsterdam, De Boelelaan 1118, PK 1Y 176, 1081 HZ Amsterdam, the Netherlands ()
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