title: Quality of life in patients with intracranial tumors: does tumor laterality matter?
abstract: OBJECTIVE Traditionally, the dominant (usually left) cerebral hemisphere is regarded as the more important one, and everyday clinical decisions are influenced by this view. However, reported results on the impact of lesion laterality are inconsistent in the scarce literature on quality of life (QOL) in patients with brain tumors. The authors aimed to study which cerebral hemisphere is the most important to patients with intracranial tumors with respect to health-related QOL (HRQOL). METHODS Two hundred forty-eight patients with unilateral, unifocal gliomas or meningiomas scheduled for primary surgery were included in this prospective cohort study. Generic HRQOL was measured using the EQ-5D-3L questionnaire preoperatively and after 4-6 weeks. Cross-sectional and longitudinal analyses of data were performed. RESULTS Tumor volumes were significantly larger in right-sided tumors at diagnosis, and language or speech problems were more common in left-sided lesions. Otherwise, no differences existed in baseline data. The median EQ-5D-3L index was 0.73 (range -0.24 to 1.00) in patients with right-sided tumors and 0.76 (range -0.48 to 1.00) in patients with left-sided tumors (p = 0.709). Due to the difference in tumor volumes at baseline, histopathology and tumor volumes were matched in 198 patients. EQ-5D-3L index scores in this 1:1 matched analysis were 0.74 (range -0.7 to 1.00) for patients with right-sided and 0.76 (range -0.48 to 1.00) for left-sided lesions (p = 0.342). In the analysis of longitudinal data, no association was found between tumor laterality and postoperative EQ-5D-3L index scores (p = 0.957) or clinically significant change in HRQOL following surgery (p = 0.793). CONCLUSIONS In an overall patient-reported QOL perspective, tumor laterality does not appear to be of significant importance for generic HRQOL in patients with intracranial tumors. This may imply that right-sided cerebral functions are underestimated by clinicians.
authors.affiliation: Departments of 1 Anesthesiology and.
authors.forename: Christina
authors.initials: C
authors.lastname: Drewes
authors.affiliation: Neurosurgery, St. Olavs University Hospital, Trondheim.|Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Lisa Millgård
authors.initials: LM
authors.lastname: Sagberg
authors.affiliation: Neurosurgery, St. Olavs University Hospital, Trondheim.|Department of Neurosurgery, Gothenburg University Hospital, Gothenburg; and.|Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden.
authors.forename: Asgeir Store
authors.initials: AS
authors.lastname: Jakola
authors.affiliation: Neurosurgery, St. Olavs University Hospital, Trondheim.|Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Ole
authors.initials: O
authors.lastname: Solheim
mesh_terms: D001932:Brain Neoplasms / Q000473:pathology* / Q000601:surgery*; D054022:Cerebrum; D005260:Female; D005910:Glioma / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000473:pathology* / Q000601:surgery*; D008579:Meningioma / Q000473:pathology* / Q000601:surgery*; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life
keywords: ASA = American Society of Anesthesiologists; HRQOL = health-related QOL; KPS = Karnofsky Performance Scale; MCID = minimum clinically important difference; QOL = quality of life; VAS = visual analog scale; brain neoplasm; laterality; oncology; quality of life