Nakajima Riho, Kinoshita Masashi, Okita Hirokazu, Nakada Mitsutoshi
Department of Occupational Therapy, Faculty of Health Science, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Japan.
Department of Neurosurgery, Faculty of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan.
J Neurooncol. 2022 Jan;156(1):173-183. doi: 10.1007/s11060-021-03904-6. Epub 2021 Nov 20.
The outcome of awake surgery has been evaluated based on functional factors, return to work, and oncological aspects, and there have been no reports directly examining QOL. This study aimed to investigate the outcome of QOL following awake surgery and to determine the functional factors influencing QOL.
Seventy patients with WHO grade II/III gliomas were included. For the assessment of QOL, we used the SF-36 and calculated summary and sub-component scores. Three summary component scores, including physical (PCS), mental (MCS), and role/social summary (RCS) component scores, were computed based on sub-component scores. Additionally, various assessments of neurological/neuropsychological function were performed. We performed univariate and multiple regression analyses to investigate the functional factors influencing the SF-36.
PCS and MCS were maintained, but only RCS was low to 42.0 ± 16.1. We then focused on the RCS and its sub-components: general health (GH), role physical (RP), social functioning (SF), and role emotional (RE). Multiple regression analysis showed following significant correlations between the sub-component scores and brain functions: GH to executive function and movement (p = 0.0033 and 0.032), RP to verbal fluency and movement (p = 0.0057 and 0.0010), and RE to verbal fluency (p = 0.020). Furthermore, when the sub-component scores were compared between groups with and without functional deficits related to GH, RP, and RE, each score was significantly lower in the groups with functional deficits (p = 0.012, 0.014, and 0.0049, respectively).
In patients who underwent awake surgery, a subset of patients had low QOL because of poor RCS. Functional factors influencing QOL included executive function, verbal fluency, and movement.
清醒手术的结果已根据功能因素、重返工作岗位情况和肿瘤学方面进行了评估,但尚无直接考察生活质量(QOL)的报告。本研究旨在调查清醒手术后的生活质量结果,并确定影响生活质量的功能因素。
纳入70例世界卫生组织(WHO)二级/三级胶质瘤患者。为评估生活质量,我们使用了SF-36量表并计算了汇总得分和子成分得分。基于子成分得分计算了三个汇总成分得分,包括身体(PCS)、心理(MCS)和角色/社会汇总(RCS)成分得分。此外,还进行了各种神经/神经心理学功能评估。我们进行了单因素和多因素回归分析,以研究影响SF-36量表的功能因素。
身体和心理成分得分保持稳定,但只有角色/社会汇总成分得分较低,为42.0±16.1。然后,我们重点关注角色/社会汇总成分得分及其子成分:总体健康(GH)、身体角色(RP)、社会功能(SF)和情感角色(RE)。多因素回归分析显示,子成分得分与脑功能之间存在以下显著相关性:总体健康与执行功能和运动相关(p = 0.0033和0.032),身体角色与语言流畅性和运动相关(p = 0.0057和0.0010),情感角色与语言流畅性相关(p = 0.020)。此外,当比较有和没有与总体健康、身体角色和情感角色相关的功能缺陷的两组之间的子成分得分时,有功能缺陷的组中每个得分均显著较低(分别为p = 0.012、0.014和0.0049)。
在接受清醒手术的患者中,一部分患者由于角色/社会汇总成分得分较低而生活质量较差。影响生活质量的功能因素包括执行功能、语言流畅性和运动。