Patients' reported outcome measures and clinical scales in brain tumor surgery: results from a prospective cohort study

Acta Neurochir (Wien). 2018 May;160(5):1053-1061. doi: 10.1007/s00701-018-3505-0. Epub 2018 Mar 3.


Background: This study aims to assess surgical outcome in brain tumor surgery using patient reported outcome measures (PROMs) and to compare their results with traditional clinical outcome measurements.

Method: Neuro-oncological patients undergoing surgical removal for the lesion were enrolled; MOCA test, PROMs (EUROHIS-QoL, PGWB-S, WHODAS-12), and the clinical scale Karnofsky Performance Status (KPS) were administered to evaluate respectively cognitive status, quality of life, well-being, disability, and functional status before surgery and at 3-month follow-up. Wilcoxon test was performed to evaluate the longitudinal change of test scores, the smallest detectable difference to classify the change of patients in PROMs, the Cohen kappa to investigate the concordance between KPS and PROMs in classifying the patients' change, and Mann-Whitney U test to compare patients with complications and no complications.

Results: A total of 101 patients were enrolled (54 woman, mean age 50.2 ± 14.1, range 20-85): psychological well-being improved at follow-up; 95 patients (94.1%) were improved/unchanged and 6 (5.9%) were worsened according to PROMs; functional status measured with KPS had a slight agreement with quality of life and disability and no agreement with psychological well-being questionnaires; patients with complications had a greater worsening in KPS.

Conclusions: According to PROMs measuring QoL, disability, and psychological well-being, most of the patients were improved/unchanged after surgery. Since PROMs and KPS detect different aspects of the patients' health status, PROMs should be integrated in surgical outcome evaluation. Furthermore, their association with complications and with other clinical and subjective variables that could influence patient's perception of health status should be investigated.

Keywords: Brain tumor; Clinical outcome; Neurosurgery; Patient reported outcomes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Brain Neoplasms / psychology
  • Brain Neoplasms / surgery*
  • Disability Evaluation
  • Female
  • Humans
  • Karnofsky Performance Status
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Patient Reported Outcome Measures
  • Prospective Studies
  • Quality of Life / psychology*
  • Surveys and Questionnaires
  • Treatment Outcome
  • Young Adult