Objective: By exploring longitudinal patient-reported health-related quality of life (HRQoL), the authors sought to assess the quality of survival for patients in the 1st year after diagnosis of glioblastoma.
Methods: Thirty unselected patients ≥ 18 years who underwent primary surgery for glioblastoma in the period 2011-2013 were included. Using the generic HRQoL questionnaire EQ-5D 3L, baseline HRQoL was assessed before surgery and at postoperative follow-up after 1, 2, 4, 6, 8, 10, and 12 months.
Results: There was an apparent correlation between deterioration in HRQoL scores and tumor progression. Patients with permanent deterioration in HRQoL early after surgery represented a subgroup with rapid progression and short survival. Both positive and negative changes in HRQoL were more often seen after surgery than after radio- or chemotherapy. Patients with gross-total resection (GTR) reported better and more stable HRQoL. In a multivariable analysis preoperative cognitive symptoms (p = 0.02), preoperative functional status (p = 0.03), and GTR (p = 0.01) were independent predictors of quality of survival (area under the curve for EQ-5D 3L index values).
Conclusions: The results indicate that progression-free survival is not only a surrogate marker for survival, but also for quality of survival. Quality of survival seems to be associated with GTR, which adds further support for opting for extensive resections in glioblastoma patients with good preoperative functional levels.
Keywords: ASA = American Society of Anesthesiologists; AUC = area under the curve; CCI = Charlson Comorbidity Index; EORTC = European Organisation for Research and Treatment of Cancer; GTR = gross-total resection; HRQoL = health-related quality of life; KPS = Karnofsky Performance Status; LOCF = last-observation-carried-forward; MCID = minimal clinically important difference; PRO = patient-reported outcome; RANO = Response Assessment in Neuro-Oncology criteria; VAS = visual analog scale; brain tumor; extent of resection; glioblastoma; oncology; outcome; quality of life; surgery.