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Repeated surgical resections for management of high-grade glioma and its impact on quality of life

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Abstract

Purpose

High-grade gliomas (HGG) are aggressive cancers, and their recurrence is inevitable, despite advances in treatment options. While repeated tumor resection has been shown to increase survival rate, its impact on quality of life is not clearly defined. To address this gap, we compared quality of life (QoL) changes in HGG patients who underwent first-time (FTR) versus repeat surgical resections (RSR) for management of recurrence.

Methods

Forty-four adults with HGG who underwent tumor resection were included in this study and classified into either the FTR group (n = 23) or the RSR group (n = 21). All patients completed comprehensive neuropsychological evaluations that included the Functional Assessment of Cancer Therapy-General (FACT-G) and Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) scales, pre-operatively and at two weeks post-operatively.

Results

There was no difference between the FTR and RSR groups in any of the QoL indices (all p > .05), except for improved emotional well-being and worsened social well-being, suggesting minimal detrimental effects of repeat surgeries on QoL in comparison to first time surgery.

Conclusions

These results suggest that repeated resection is a viable strategy in certain cases for management of HGG recurrence, with similar impact on QoL as observed in patients undergoing first time surgery. These encouraging outcomes provide useful insight to guide treatment strategies and patient and clinician decision making to optimize surgical and functional outcomes.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Funding

AQH acknowledges support from the William J. and Charles H. Mayo Professorship, the Mayo Clinic Clinician Investigator Award, the Florida Department of Health Cancer Research Chair Fund, and the Monica Flynn Jacoby Endowed Chair, NIH R01CA282451, NIH R01NS129671 and NIH R01CA284268.

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Authors and Affiliations

  1. Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Jun Min Koay

  2. Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, USA

    Jun Min Koay & David S. Sabsevitz

  3. Department of Neurological Surgery, Mayo Clinic, Jacksonville, FL, USA

    Loizos Michaelides, Diogo P. Moniz-Garcia, Alfredo Quinones-Hinojosa, Kaisorn Chaichana, Joao Paulo Almeida, Wendy J. Sherman & David S. Sabsevitz

  4. Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, FL, USA

    Benjamin F. Gruenbaum

  5. Department of Neurology, Mayo Clinic, Jacksonville, FL, USA

    Wendy J. Sherman

Authors
  1. Jun Min Koay
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  2. Loizos Michaelides
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  4. Alfredo Quinones-Hinojosa
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Contributions

J.M.K. and D.S.S. contributed to the study conception and design. Material preparation and data collection were performed by J.M.K., L.M., D.M.G., A.Q.H., K.C., J.P.C.A., D.S.S. Analysis were performed by J.M.K. and D.S.S. The first draft of the manuscript was written by J.M.K. and D.S.S. All authors critically reviewed and revised the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jun Min Koay.

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The authors declare no competing interests.

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This study was approved by the Mayo Clinic Institutional Review Board (IRB# 16–009946).

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Koay, J.M., Michaelides, L., Moniz-Garcia, D.P. et al. Repeated surgical resections for management of high-grade glioma and its impact on quality of life. J Neurooncol 167, 267–273 (2024). https://doi.org/10.1007/s11060-024-04600-x

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  • DOI: https://doi.org/10.1007/s11060-024-04600-x

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