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Law K, Harris E, McCabe MG, Yorke J, van der Veer SN. Measurement Properties of Patient-Reported Outcome Measures for Adolescent and Young Adult Survivors of a Central Nervous System Tumor: A Systematic Review. J Adolesc Young Adult Oncol 2024; 13:40-54. [PMID: 37307017 PMCID: PMC10877386 DOI: 10.1089/jayao.2023.0048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023] Open
Abstract
Purpose: To identify and evaluate patient-reported outcome measures (PROMs) for assessing survivorship-related concepts for adolescent and young adult (AYA) survivors of central nervous system (CNS) tumors. Methods: We searched five electronic databases. Two researchers independently screened all titles for inclusion and used consensus-based standards for the selection of health measurement instruments (COSMIN) guidance to grade the quality of evidence for each measurement property. Results: Four studies met eligibility criteria: single-item pain thermometer; single-item fatigue thermometer; 37-item pediatric functional assessment of cancer therapy-brain tumor survivors, measuring quality of life; and 12-item Perceived Barriers Scale to assess barriers to employment. The Perceived Barrier Scale showed high-quality evidence for internal consistency and moderate quality evidence for construct and structural validity. Evidence for the measurement properties of the other PROMs was low-to-moderate quality. Conclusion: We found one PROM with sufficient evidence for good measurement properties to support its use. This warrants development and evaluation of further PROMs to inform ongoing supportive care for this population. Implications for Cancer Survivors: The Perceived Barriers Scale is sufficiently validated and could be considered to guide support for AYA survivors of CNS tumors to achieve their employment goals.
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Affiliation(s)
- Kate Law
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
- The Christie Hospital NHS Foundation Trust, Manchester, United Kingdom
| | - Emily Harris
- The Christie Hospital NHS Foundation Trust, Manchester, United Kingdom
| | - Martin G. McCabe
- The Christie Hospital NHS Foundation Trust, Manchester, United Kingdom
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Janelle Yorke
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
- The Christie Hospital NHS Foundation Trust, Manchester, United Kingdom
| | - Sabine N. van der Veer
- Centre for Health Informatics, Division of Informatics, Imaging and Data Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
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Abstract
Background. Meningiomas are the most common primary intracranial tumor in adults. Although frequently histologically benign, the clinical severity of a lesion may range from being asymptomatic to causing severe impairment of global function and well-being. The diversity of intracranial locations and clinical phenotypes poses a challenge when studying functional impairments, however, more recent attention to patient-reported outcomes and health-related quality of life (HRQOL) have helped to improve our understanding of how meningioma may impact a patient’s life.Methods. Treatment strategies such as observation, surgery, radiation, or a combination thereof have been examined to ascertain their contributions to symptoms, physical and cognitive functioning, disability, and general aspects of daily functioning.Results. This review explores the multidimensional nature of HRQOL and how patients may be influenced by meningiomas and their treatment.Conclusion. Overall, treatment of symptomatic meningiomas is associated with improved HRQOL, cognitive functioning, and seizure control while tumor size, location, histologic grade, and epileptic burden are associated with worse HRQOL.
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Affiliation(s)
- Sameah Haider
- Department of Neurosurgery, Hermelin Brain Tumor Center, Henry Ford Health System, Detroit, Michigan, USA
| | - Martin J B Taphoorn
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.,Department of Neurology, Haaglanden Medical Center, The Hague, The Netherlands
| | - Katharine J Drummond
- Department of Neurosurgery, Royal Melbourne Hospital, Parkville, Victoria, Australia.,Department of Surgery, University of Melbourne, Parkville, Victoria, Australia
| | - Tobias Walbert
- Department of Neurosurgery, Hermelin Brain Tumor Center, Henry Ford Health System, Detroit, Michigan, USA
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Zamanipoor Najafabadi AH, van der Meer PB, Boele FW, Taphoorn MJB, Klein M, Peerdeman SM, van Furth WR, Dirven L. Determinants and predictors for the long-term disease burden of intracranial meningioma patients. J Neurooncol 2020; 151:201-210. [PMID: 33073326 PMCID: PMC7875939 DOI: 10.1007/s11060-020-03650-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 10/12/2020] [Indexed: 01/04/2023]
Abstract
Introduction Meningioma is a heterogeneous disease and patients may suffer from long-term tumor- and treatment-related sequelae. To help identify patients at risk for these late effects, we first assessed variables associated with impaired long-term health-related quality of life (HRQoL) and impaired neurocognitive function on group level (i.e. determinants). Next, prediction models were developed to predict the risk for long-term neurocognitive or HRQoL impairment on individual patient-level. Methods Secondary data analysis of a cross-sectional multicenter study with intracranial WHO grade I/II meningioma patients, in which HRQoL (Short-Form 36) and neurocognitive functioning (standardized test battery) were assessed. Multivariable regression models were used to assess determinants for these outcomes corrected for confounders, and to build prediction models, evaluated with C-statistics. Results Data from 190 patients were analyzed (median 9 years after intervention). Main determinants for poor HRQoL or impaired neurocognitive function were patients’ sociodemographic characteristics, surgical complications, reoperation, radiotherapy, presence of edema, and a larger tumor diameter on last MRI. Prediction models with a moderate/good ability to discriminate between individual patients with and without impaired HRQoL (C-statistic 0.73, 95% CI 0.65 to 0.81) and neurocognitive function (C-statistic 0.78, 95%CI 0.70 to 0.85) were built. Not all predictors (e.g. tumor location) within these models were also determinants. Conclusions The identified determinants help clinicians to better understand long-term meningioma disease burden. Prediction models can help early identification of individual patients at risk for long-term neurocognitive or HRQoL impairment, facilitating tailored provision of information and allocation of scarce supportive care services to those most likely to benefit. Electronic supplementary material The online version of this article (10.1007/s11060-020-03650-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Amir H Zamanipoor Najafabadi
- Department of Neurosurgery, University Neurosurgical Center Holland, Leiden University Medical Center, Albinusdreef 2, Postal Zone J11-R, 2333ZA, Leiden, The Netherlands. .,Haaglanden Medical Center & Haga Teaching Hospitals, The Hague, The Netherlands. .,Department of Neurology, Leiden University Medical Center, Albinusdreef 2, Postal Zone J11-R, 2333ZA, Leiden, The Netherlands.
| | - Pim B van der Meer
- Department of Neurology, Leiden University Medical Center, Albinusdreef 2, Postal Zone J11-R, 2333ZA, Leiden, The Netherlands
| | - Florien W Boele
- Leeds Institute of Medical Research at St James's, St James's University Hospital, Leeds, LS9 7TF, UK.,Faculty of Medicine and Health, Leeds Institute of Health Sciences, University of Leeds, Leeds, LS2 9JT, UK
| | - Martin J B Taphoorn
- Department of Neurology, Leiden University Medical Center, Albinusdreef 2, Postal Zone J11-R, 2333ZA, Leiden, The Netherlands.,Department of Neurology, Haaglanden Medical Center, The Hague, The Netherlands
| | - Martin Klein
- Department of Medical Psychology, Brain Tumor Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Saskia M Peerdeman
- Department of Neurosurgery, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Wouter R van Furth
- Department of Neurosurgery, University Neurosurgical Center Holland, Leiden University Medical Center, Albinusdreef 2, Postal Zone J11-R, 2333ZA, Leiden, The Netherlands.,Haaglanden Medical Center & Haga Teaching Hospitals, The Hague, The Netherlands
| | - Linda Dirven
- Department of Neurology, Leiden University Medical Center, Albinusdreef 2, Postal Zone J11-R, 2333ZA, Leiden, The Netherlands.,Department of Neurology, Haaglanden Medical Center, The Hague, The Netherlands
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Zamanipoor Najafabadi AH, Peeters MCM, Dirven L, Lobatto DJ, Groen JL, Broekman MLD, Peerdeman SM, Peul WC, Taphoorn MJB, van Furth WR. Impaired health-related quality of life in meningioma patients-a systematic review. Neuro Oncol 2017; 19:897-907. [PMID: 28039363 PMCID: PMC5570251 DOI: 10.1093/neuonc/now250] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
While surgical and radiotherapeutic improvements increased life expectancy of meningioma patients, little is known about these patients' health-related quality of life (HRQoL). Therefore, the objectives of this systematic review were to assess HRQoL in meningioma patients, the methodological quality of the used questionnaires (COSMIN criteria), and the reporting level of patient-reported outcomes (PROs) in the included studies (International Society of Quality of Life Research criteria).Nineteen articles met our inclusion criteria. HRQoL was measured with 13 different questionnaires, 3 validated in meningioma patients. According to our predefined cutoff, HRQoL data were reported sufficiently in 5 out of 19 studies. Both findings hamper interpretation of the PRO results.In general, meningioma patients reported clinically worse HRQoL than healthy controls. Although meningioma patients had better HRQoL than glioma patients, this difference was not clinically relevant. Radiotherapy seemed to improve some domains of HRQoL in the short term, while HRQoL decreased to pre-radiotherapy levels in the long term. Tumor resection increased HRQoL, but long-term follow-up showed persistent reduced HRQoL compared with healthy controls. These results suggest an impaired HRQoL in meningioma patients, even years after anti-tumor treatment. Results of this systematic review warrant high quality prospective studies, better instruments to assess HRQoL, and improved level of reporting for this group of patients.
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Affiliation(s)
- Amir H Zamanipoor Najafabadi
- Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands; Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands; Department of Neurosurgery, Utrecht Medical Center, Utrecht, The Netherlands; Department of Neurosurgery, VU Medical Center, Amsterdam, The Netherlands; Department of Neurosurgery, Medical Center Haaglanden, The Hague, The Netherlands; Department of Neurology, Medical Center Haaglanden, The Hague, The Netherlands
| | - Marthe C M Peeters
- Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands; Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands; Department of Neurosurgery, Utrecht Medical Center, Utrecht, The Netherlands; Department of Neurosurgery, VU Medical Center, Amsterdam, The Netherlands; Department of Neurosurgery, Medical Center Haaglanden, The Hague, The Netherlands; Department of Neurology, Medical Center Haaglanden, The Hague, The Netherlands
| | - Linda Dirven
- Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands; Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands; Department of Neurosurgery, Utrecht Medical Center, Utrecht, The Netherlands; Department of Neurosurgery, VU Medical Center, Amsterdam, The Netherlands; Department of Neurosurgery, Medical Center Haaglanden, The Hague, The Netherlands; Department of Neurology, Medical Center Haaglanden, The Hague, The Netherlands
| | - Daniel J Lobatto
- Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands; Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands; Department of Neurosurgery, Utrecht Medical Center, Utrecht, The Netherlands; Department of Neurosurgery, VU Medical Center, Amsterdam, The Netherlands; Department of Neurosurgery, Medical Center Haaglanden, The Hague, The Netherlands; Department of Neurology, Medical Center Haaglanden, The Hague, The Netherlands
| | - Justus L Groen
- Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands; Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands; Department of Neurosurgery, Utrecht Medical Center, Utrecht, The Netherlands; Department of Neurosurgery, VU Medical Center, Amsterdam, The Netherlands; Department of Neurosurgery, Medical Center Haaglanden, The Hague, The Netherlands; Department of Neurology, Medical Center Haaglanden, The Hague, The Netherlands
| | - Marieke L D Broekman
- Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands; Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands; Department of Neurosurgery, Utrecht Medical Center, Utrecht, The Netherlands; Department of Neurosurgery, VU Medical Center, Amsterdam, The Netherlands; Department of Neurosurgery, Medical Center Haaglanden, The Hague, The Netherlands; Department of Neurology, Medical Center Haaglanden, The Hague, The Netherlands
| | - Saskia M Peerdeman
- Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands; Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands; Department of Neurosurgery, Utrecht Medical Center, Utrecht, The Netherlands; Department of Neurosurgery, VU Medical Center, Amsterdam, The Netherlands; Department of Neurosurgery, Medical Center Haaglanden, The Hague, The Netherlands; Department of Neurology, Medical Center Haaglanden, The Hague, The Netherlands
| | - Wilo C Peul
- Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands; Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands; Department of Neurosurgery, Utrecht Medical Center, Utrecht, The Netherlands; Department of Neurosurgery, VU Medical Center, Amsterdam, The Netherlands; Department of Neurosurgery, Medical Center Haaglanden, The Hague, The Netherlands; Department of Neurology, Medical Center Haaglanden, The Hague, The Netherlands
| | - Martin J B Taphoorn
- Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands; Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands; Department of Neurosurgery, Utrecht Medical Center, Utrecht, The Netherlands; Department of Neurosurgery, VU Medical Center, Amsterdam, The Netherlands; Department of Neurosurgery, Medical Center Haaglanden, The Hague, The Netherlands; Department of Neurology, Medical Center Haaglanden, The Hague, The Netherlands
| | - Wouter R van Furth
- Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands; Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands; Department of Neurosurgery, Utrecht Medical Center, Utrecht, The Netherlands; Department of Neurosurgery, VU Medical Center, Amsterdam, The Netherlands; Department of Neurosurgery, Medical Center Haaglanden, The Hague, The Netherlands; Department of Neurology, Medical Center Haaglanden, The Hague, The Netherlands
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Miao Y, Lu X, Qiu Y, Jiang J, Lin Y. A multivariate analysis of prognostic factors for health-related quality of life in patients with surgically managed meningioma. J Clin Neurosci 2010; 17:446-9. [PMID: 20138525 DOI: 10.1016/j.jocn.2009.07.111] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2009] [Revised: 07/18/2009] [Accepted: 07/20/2009] [Indexed: 11/16/2022]
Abstract
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.
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Affiliation(s)
- Yifeng Miao
- Department of Neurosurgery, Wuxi No. 2 Hospital, Nanjing Medical University, 68 Zhongshan Road, Wuxi, China
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