A multivariate analysis of prognostic factors for health-related quality of life in patients with surgically managed meningioma.

The objective of this study was to examine the prognostic significance of health-related quality of life (HQOL) parameters combined with baseline clinical factors in patients undergoing neurosurgery for treatment of meningioma. A total of 147 patients (61 male, 86 female; mean age 43 years, range 5-77 years) who underwent resection of a meningioma between January 2002 and December 2004 were studied. HQOL was evaluated using a modified questionnaire based on the World Health Organization Quality of Life-100 Scale and the Karnofsky Performance Scale. The relationships between HQOL and clinical history, radiological findings, extent of resection, histological grade and recurrence were investigated using multivariate analysis. The mean HQOL score was 73.94+/-1.79 for preoperative patients with meningioma, 84.88+/-2.14 for postoperative patients, and 91.13+/-1.61 for healthy controls. HQOL for patients with meningioma was significantly lower than that for normal controls (P<0.001), and postoperative patients had a more satisfactory HQOL than preoperative (P<0.05). Cox proportional hazards analysis showed that significant predictors of health-related quality of life were tumor size, extent of surgical excision, and histologic grade. Multivariate backward logistic regression yielded the regression equation HQOL=119.1097 - 1.5002X(3) - 8.6650X(6) - 10.4210X(7) (R=0.7466; where X(3) is tumor size, X(6) is extent of surgical excision, and X(7) is the histologic grade of the tumor). This equation can be used preoperatively to predict the HQOL of meningioma patients after neurosurgery. A specialized HQOL questionnaire for patients with meningioma provides useful information when planning the operative procedure, and may make it more likely that patients have a satisfactory HQOL after surgery.