Quality of life following surgery for anterior skull base tumors.
OBJECTIVE
To evaluate patients' quality of life (QOL) after surgical extirpation of anterior skull base tumors, to elucidate different QOL domains, and to define possible predictors of functional outcome postoperatively.


METHODS
Retrospective survey.


METHODS
University-affiliated medical center.


METHODS
Sixty-nine patients (76 consecutive cases) who underwent subcranial surgery between 1994 and 2002 for extirpation of anterior skull base tumors.


METHODS
A multidimensional, disease-specific questionnaire with 39 items was used. Six relevant domains of QOL were assessed: role of performance, physical functioning, vitality, pain, specific symptoms, and impact on emotions.


RESULTS
The response rate for completing the questionnaire was 98% (40/41) after excluding patients who died (n = 13), were lost to follow-up (n = 10), and were operated on within 3 months of commencement of the study (n = 5). Thirty patients (74%) reported a significant improvement or no change in overall QOL within 6 months after surgery. The worst impact of surgery on the patients' QOL was on their financial status and emotional state. The most influential factor on QOL was malignancy leading to a significant decrease in the overall score. Radiotherapy, old age, comorbidity, and wide resection also significantly worsened QOL scores of specific domains.


CONCLUSIONS
After subcranial extirpation of anterior skull base tumors, the overall outcome of the patients is good. Old age, malignancy, comorbidity, wide resection, and radiotherapy are negative prognostic factors for these patients' QOL.
Gil
Ziv
Z
Department of Otolaryngology-Head and Neck Surgery and the Skull Base Surgery Unit, Tel-Aviv Sourasky Medical Center, 6 Weizman Street, Tel-Aviv, Israel 64239. ziv@dot.co.il
Abergel
Avraham
A
Spektor
Sergei
S
Cohen
Jacob T
JT
Khafif
Avi
A
Shabtai
Esther
E
Fliss
Dan M
DM
D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D001294:Attitude to Health; D015897:Comorbidity; D035262:Cranial Fossa, Anterior; D004644:Emotions; D005163:Factor Analysis, Statistical; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology / Q000523:psychology; D011237:Predictive Value of Tests; D011379:Prognosis; D011788:Quality of Life / Q000523:psychology*; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects / Q000523:psychology; D012189:Retrospective Studies; D019292:Skull Base Neoplasms / Q000523:psychology* / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome