title: Quality of survival the 1st year with glioblastoma: a longitudinal study of patient-reported quality of life.
abstract: 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.
authors.affiliation: Department of Neurosurgery, St. Olavs University Hospital;|Department of Neuroscience, Norwegian University of Science and Technology;|National Competence Centre for Ultrasound and Image-Guided Therapy, Trondheim, Norway; and.
authors.forename: Lisa Millgård
authors.initials: LM
authors.lastname: Sagberg
authors.affiliation: Department of Neurosurgery, St. Olavs University Hospital;|Department of Neuroscience, Norwegian University of Science and Technology;|National Competence Centre for Ultrasound and Image-Guided Therapy, Trondheim, Norway; and.
authors.forename: Ole
authors.initials: O
authors.lastname: Solheim
authors.affiliation: Department of Neurosurgery, St. Olavs University Hospital;|Sahlgrenska University Hospital, Department of Neurosurgery, Gothenburg, Sweden.
authors.forename: Asgeir S
authors.initials: AS
authors.lastname: Jakola
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000453:epidemiology* / Q000523:psychology* / Q000601:surgery; D059248:Chemoradiotherapy; D003072:Cognition Disorders / Q000209:etiology / Q000523:psychology; D003131:Combined Modality Therapy; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D005909:Glioblastoma / Q000453:epidemiology* / Q000523:psychology* / Q000601:surgery; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000523:psychology; D011379:Prognosis; D011788:Quality of Life / Q000523:psychology; D016019:Survival Analysis
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