Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway.
Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.
J Neurooncol. 2020 Mar;147(1):97-107. doi: 10.1007/s11060-020-03403-0. Epub 2020 Jan 23.
Few studies have assessed fatigue in relation to glioma surgery. The purpose of this study was to explore the prevalence of pre- and postoperative high fatigue, perioperative changes, and factors associated with pre- and postoperative high fatigue in patients undergoing primary surgery for diffuse glioma.
A total of 112 adult patients were prospectively included. Patient-reported fatigue was assessed before and one month after surgery using the cancer-specific European Organization for Research and Treatment of Cancer questionnaire fatigue subscale. The scores were dichotomized as high fatigue (≥ 39) or low fatigue (< 39). A change in score of ≥ 10 was considered as a clinically significant change. Factors associated with pre- and postoperative high fatigue were explored in multivariable regression analyses.
High fatigue was reported by 45% of the patients preoperatively and by 42% of the patients postoperatively. Female gender and low Karnofsky Performance Status (KPS) were associated with preoperative high fatigue, while postoperative complications, low KPS and low-grade histopathology were associated with postoperative high fatigue. In total 35/92 (38%) patients reported a clinically significant improvement of fatigue scores after surgery, 36/92 (39%) patients reported a clinically significant worsening of fatigue scores after surgery, and 21/92 (23%) patients reported no clinically significant change in fatigue scores after surgery. Patients with low-grade gliomas more often reported low fatigue before surgery and high fatigue after surgery, while patients with high-grade gliomas more often reported high fatigue before surgery and low fatigue after surgery.
Our findings indicate that fatigue is a common symptom in patients with diffuse glioma, both pre- and postoperatively. Perioperative changes were frequently seen. This is important knowledge when informing patients before and after surgery.
很少有研究评估胶质瘤手术与疲劳的关系。本研究旨在探讨原发性弥漫性胶质瘤患者术前和术后高疲劳的发生率、围手术期变化以及与术前和术后高疲劳相关的因素。
共前瞻性纳入 112 例成年患者。使用欧洲癌症研究与治疗组织癌症特定问卷疲劳量表亚量表在术前和术后一个月评估患者报告的疲劳。将评分分为高疲劳（≥39）或低疲劳（<39）。评分变化≥10 被认为具有临床意义。在多变量回归分析中探讨了与术前和术后高疲劳相关的因素。
45%的患者术前报告高疲劳，42%的患者术后报告高疲劳。女性和低 Karnofsky 表现状态（KPS）与术前高疲劳相关，而术后并发症、低 KPS 和低级别组织病理学与术后高疲劳相关。共有 35/92（38%）例患者报告术后疲劳评分有临床显著改善，36/92（39%）例患者报告术后疲劳评分有临床显著恶化，21/92（23%）例患者报告术后疲劳评分无临床显著变化。低级别胶质瘤患者术前更常报告疲劳程度低，术后更常报告疲劳程度高，而高级别胶质瘤患者术前更常报告疲劳程度高，术后更常报告疲劳程度低。
我们的研究结果表明，疲劳是弥漫性胶质瘤患者术前和术后的常见症状。围手术期变化很常见。这是在手术前后告知患者时的重要知识。
