Cognitive function as a predictor of survival in patients with recurrent malignant glioma.
OBJECTIVE
To determine the contribution of cognitive function in predicting the survival of patients with recurrent malignant brain tumors.


METHODS
A total of 80 patients with recurrent glioblastoma multiforme or anaplastic astrocytoma were seen for baseline evaluations before beginning a phase I or phase II clinical trial. Each patient received a battery of nine brief tests measuring cognitive function, ability to perform activities of daily living (ADLs), and quality of life (QOL). Tests were given monthly after treatment was begun.


RESULTS
Performance on a test of verbal memory was independently and strongly related to survival after accounting for age, Karnofsky performance status score, histology, and time since diagnosis. Models incorporating three of nine and all nine tests in the battery accounted for significantly more variance in survival than did the clinical variables alone. Measures of QOL and ADLs (bathing, feeding, and so on) were not independently related to survival, although they provide clinical information that is important for patient care.


CONCLUSIONS
These results indicate that a multifaceted assessment of cognition, QOL, and patient function is practical for brain tumor patients in clinical trials and can provide information regarding the relative risks versus benefits of new treatment regimens that supplements the information from the usual clinical variables.
Meyers
C A
CA
Departments of Neuro-Oncology and Biomathematics, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA. cameyers@mdanderson.org
Hess
K R
KR
Yung
W K
WK
Levin
V A
VA
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D001254:Astrocytoma / Q000503:physiopathology* / Q000523:psychology; D001932:Brain Neoplasms / Q000503:physiopathology* / Q000523:psychology; D003072:Cognition Disorders / Q000503:physiopathology*; D005260:Female; D005909:Glioblastoma / Q000503:physiopathology* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011788:Quality of Life; D012044:Regression Analysis; D016019:Survival Analysis