Long term quality of life outcomes following surgical resection alone for benign paediatric intracranial tumours

Siddhant Kumar; Abdurrahman I Islim; Richard Moon; Christopher P Millward; Dawn Hennigan; Antonia Thorpe; Mitchell Foster; Barry Pizer; Conor L Mallucci; Michael D Jenkinson

doi:10.1007/s11060-022-04208-z

Long term quality of life outcomes following surgical resection alone for benign paediatric intracranial tumours

J Neurooncol. 2023 Jan;161(1):77-84. doi: 10.1007/s11060-022-04208-z. Epub 2023 Jan 2.

Authors

Siddhant Kumar^{1

2}, Abdurrahman I Islim^{3

4}, Richard Moon⁵, Christopher P Millward^{6

7}, Dawn Hennigan⁸, Antonia Thorpe⁶, Mitchell Foster⁶, Barry Pizer⁹, Conor L Mallucci⁸, Michael D Jenkinson^{6

7}

Affiliations

¹ Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Fazakerley, Liverpool, L9 7LJ, UK. Siddhant.kumar@doctors.org.uk.
² Institute of Systems, Molecular and Integrative Biology, The University of Liverpool, Liverpool, UK. Siddhant.kumar@doctors.org.uk.
³ Department of Neurosurgery, Salford Royal Hospital Foundation Trust, Manchester, UK.
⁴ Academic Health Science Centre, University of Manchester, Manchester, UK.
⁵ Department of Neurosurgery, North Bristol NHS Trust, Bristol, UK.
⁶ Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Fazakerley, Liverpool, L9 7LJ, UK.
⁷ Institute of Systems, Molecular and Integrative Biology, The University of Liverpool, Liverpool, UK.
⁸ Department of Neurosurgery, Alder Hey Children's NHS Foundation Trust, Liverpool, UK.
⁹ Department of Paediatric Oncology, Alder Hey Children's NHS Foundation Trust, Liverpool, UK.

PMID: 36592264
DOI: 10.1007/s11060-022-04208-z

Abstract

Purpose: Survivors of paediatric intracranial tumours are at increased risk of psychosocial, neuro-developmental, and functional impairment. This study aimed to evaluate long-term health-related quality-of-life (HRQOL) outcomes in patients with benign paediatric brain tumours treated curatively with surgical resection alone.

Methodology: This was a cross-sectional study of patients with benign paediatric intracranial tumours managed with surgery alone between 2000 and 2015. Eligible patients with a minimum of 5-years follow-up after surgery were identified. Validated health-related quality of life (HRQOL) questionnaires were administered: SF-36, QLQ-BN20, QLQ-C30 and PedsQL™.

Results: Twenty-three patients participated (median age at surgery 13 years; range 1-18; 12 male). The most common diagnosis was pilocytic astrocytoma (n = 15). Median time from surgery to participation was 11 years(range 6-19). Fourteen patients achieved A-level qualifications and two obtained an undergraduate degree. Twelve patients were employed, eight were studying and three were unemployed or volunteering. HRQOL outcomes demonstrated significant limitation from social functioning (p = 0.03) and cognitive functioning (p = 0.023) compared to the general population. Patients also experienced higher rates of loss of appetite (p = 0.009) and nausea and vomiting (p = 0.031). Ten patients were under transitional teenager and young-adult (TYA) clinic follow-up. TYA patients achieved higher levels of education (p = 0.014), were more likely to hold a driver's license (p = 0.041) compared to patients not followed-up through these services.

Conclusions: Childhood brain-tumour survivors have a greater risk of developing psychological, neuro-cognitive and physical impairment. Early comprehensive assessment, specialist healthcare and TYA services are vital to support these patients.

Keywords: Benign; Brain tumours; Childood; Quality of life; Surgery; Survivors.

MeSH terms

Adolescent
Adult
Astrocytoma* / therapy
Brain Neoplasms* / therapy
Child
Cross-Sectional Studies
Humans
Male
Quality of Life
Surveys and Questionnaires
Survivors