University Neurosurgical Center Holland, Leiden University Medical Center, Haaglanden Medical Center and Haga Teaching Hospital, Leiden and The Hague, the Netherlands.
Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands.
Neurosurgery. 2020 Dec 15;88(1):155-164. doi: 10.1093/neuros/nyaa351.
Many intracranial meningioma patients have an impaired health-related quality of life (HRQoL) and neurocognitive functioning up to 4 yr after intervention.
To assess the long-term (≥5 yr) disease burden of meningioma patients.
In this multicenter cross-sectional study, patients ≥5 yr after intervention (including active magnetic resonance imaging (MRI) surveillance) were included and assessed for HRQoL (Short-Form Health Survey 36), neurocognitive functioning (neuropsychological assessment), anxiety and depression (Hospital Anxiety and Depression Scale), and work productivity (Short Form-Health and Labour Questionnaire). Multivariable and propensity score regression analyses were used to compare patients and controls, and different treatment strategies corrected for possible confounders. Clinically relevant differences were reported.
At a median of 9 yr follow-up after intervention, meningioma patients (n = 190) reported more limitations due to physical (difference 12.5 points, P = .008) and emotional (13.3 points, P = .002) health problems compared with controls. Patients also had an increased risk to suffer from anxiety (odds ratio [OR]: 2.6, 95% CI: 1.2-5.7) and depression (OR: 3.7, 95% CI: 1.3-10.5). Neurocognitive deficits were found in 43% of patients. Although postoperative complications, radiotherapy, and reresection were associated with worse verbal memory, attention, and executive functioning when compared to patients resected once, the only clinically relevant association was between reresection and worse attention (-2.11, 95% CI: -3.52 to -0.07). Patients of working age less often had a paid job (48%) compared with the working-age Dutch population (72%) and reported more obstacles at work compared with controls.
In the long term, a large proportion of meningioma patients have impaired HRQoL, neurocognitive deficits, and high levels of anxiety or depression. Patients treated with 1 resection have the best neurocognitive functioning.
许多颅内脑膜瘤患者在干预后 4 年内仍存在健康相关生活质量（HRQoL）受损和神经认知功能障碍。
评估脑膜瘤患者的长期（≥5 年）疾病负担。
在这项多中心横断面研究中，纳入了干预后≥5 年（包括主动磁共振成像（MRI）监测）的患者，并评估了 HRQoL（简短健康调查 36 项）、神经认知功能（神经心理学评估）、焦虑和抑郁（医院焦虑和抑郁量表）以及工作生产力（简短健康和劳动力问卷）。使用多变量和倾向评分回归分析比较了患者和对照组，并针对可能的混杂因素校正了不同的治疗策略。报告了临床相关差异。
在干预后中位数为 9 年的随访中，脑膜瘤患者（n=190）报告在身体（差异 12.5 分，P=0.008）和情绪（13.3 分，P=0.002）健康问题方面存在更多限制，与对照组相比。患者也有更高的焦虑（比值比[OR]：2.6，95%置信区间[CI]：1.2-5.7）和抑郁（OR：3.7，95%CI：1.3-10.5）的风险。43%的患者存在神经认知缺陷。虽然与术后并发症、放疗和再次切除术相比，一次切除术的患者在言语记忆、注意力和执行功能方面的神经认知功能下降，但唯一具有临床相关性的是再次切除术与注意力下降（-2.11，95%CI：-3.52 至-0.07）之间的关联。处于工作年龄的患者比处于工作年龄的荷兰人群（72%）更少拥有一份有薪工作（48%），并且与对照组相比，他们在工作中遇到的障碍更多。
从长远来看，很大一部分脑膜瘤患者存在 HRQoL 受损、神经认知缺陷以及焦虑或抑郁程度较高的情况。接受 1 次切除术治疗的患者具有最佳的神经认知功能。
