Postoperative Deterioration in Health Related Quality of Life as Predictor for Survival in Patients with Glioblastoma A Prospective Study 英文参考文献.docVIP

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Postoperative Deterioration in Health Related Quality of Life as Predictor for Survival in Patients with Glioblastoma A Prospective Study 英文参考文献.doc

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Postoperative Deterioration in Health Related Quality of Life as Predictor for Survival in Patients with Glioblastoma A Prospective Study 英文参考文献

PostoperativeDeteriorationinHealthRelatedQualityof LifeasPredictorforSurvivalinPatientswith Glioblastoma:AProspectiveStudy AsgeirS.Jakola1,2,3*,SashaGulati1,4,ClemensWeber1,GeirmundUnsga?rd1,3,OleSolheim1,2,3 1DepartmentofNeurosurgery,St.OlavsUniversityHospital,Trondheim,Norway,2MedicalImagingLabandDepartmentofCirculationandMedicalImaging,Norwegian University of Science and Technology, Trondheim, Norway, 3Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway, 4DepartmentofLaboratoryMedicine,Children’sandWomen’sHealth,NorwegianUniversityofScienceandTechnology,Trondheim,Norway Abstract Background: Studies indicate that acquired deficits negatively affect patients’ self-reported health related quality of life (HRQOL)andsurvival,buttheimpactofHRQOLdeteriorationaftersurgeryonsurvivalhasnotbeenexplored. Objective:AssessifchangeinHRQOLaftersurgeryisapredictorforsurvivalinpatientswithglioblastoma. Methods:Sixty-onepatientswithglioblastomawereincluded.Themajorityofpatients(n=56,91.8%)wereoperatedusing aneuronavigationsystemwhichutilizes3DpreoperativeMRIandupdatedintraoperative3Dultrasoundvolumestoguide resection. HRQOL was assessed using EuroQol 5D (EQ-5D), a generic instrument. HRQOL data were collected 1–3 days preoperativelyandafter6weeks.ThemeanchangeinEQ-5Dindexwas20.05(95%CI20.15–0.05)6weeksaftersurgery (p=0.285). There were 30 patients (49.2%) reporting deterioration 6 weeks after surgery. In a Cox multivariate survival analysis we evaluated deterioration in HRQOL after surgery together with established risk factors (age, preoperative condition,radiotherapy,temozolomideandextentofresection). Results:Thereweresignificantindependentassociationsbetweensurvivalanduseoftemozolomide(HR0.30,p=0.019), radiotherapy (HR 0.26, p=0.030), and deterioration in HRQOL after surgery (HR 2.02, p=0.045). Inclusion of surgically acquireddeficitsinthemodeldidnotaltertheconclusion. Conclusion:EarlydeteriorationinHRQOLaftersurgeryisindependentlyandm