Article
Psychological burden under watchful waiting versus after complete meningioma resection – prospective observational study
Psychische Belastung bei Patienten mit Meningeom unter Beobachtung verglichen mit Patienten nach kompletter Resektion – eine prospektive Beobachtungsstudie
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Authors
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Darius Kalasauskas
- Universitätsmedizin Mainz, Klinik und Poliklinik für Neurochirurgie, Mainz, Deutschland
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Salman Abu Ajaj
- Universitätsmedizin Mainz, Klinik und Poliklinik für Neurochirurgie, Mainz, Deutschland
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Leonie von Cube
- Universitätsmedizin Mainz, Klinik und Poliklinik für Neurochirurgie, Mainz, Deutschland
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Naureen Keric
- Universitätsmedizin Mainz, Klinik und Poliklinik für Neurochirurgie, Mainz, Deutschland
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Florian Ringel
- Universitätsmedizin Mainz, Klinik und Poliklinik für Neurochirurgie, Mainz, Deutschland
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Mirjam Renovanz
- Universitätsmedizin Mainz, Klinik und Poliklinik für Neurochirurgie, Mainz, Deutschland; Universitätsklinikum Tübingen, Klinik für Neurochirurgie, Tübingen, Deutschland
| Published: | June 26, 2020 |
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Outline
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Objective: The diagnosis of a brain tumor is usually a life changing event. But what if the tumor is a small and benign one, or if it is totally removed? In this study, we aim to investigate psychological burden in patients with meningiomas with recommendation of watchful waiting compared to patients with a good outcome after complete resection.
Methods: Patients with small asymptomatic meningiomas under watchful waiting strategy and patients after complete meningioma resection, demonstrating no focal neurological deficits who gave informed consent were included. Exclusion criteria were any other known malignancies. Patients were evaluated for psychological burden using Hospital Anxiety and Depression Scale (<8 - no anxiety/depression, 8-10 - borderline case, 11-21 - anxiety/depression) and Distress Thermometer (DT) (score ≥ 6 indicated significant burden) during an outpatient visit. A follow-up survey was sent to the patients 3 months after the interview. Demographic, tumor-related and performance data were using Chi-Square as well as univariate and multivariate regression analyses.
Results: Out of n=55, n=48 patients (mean age 59.3(SD 12.8), 83.3% women) were included so far. Conservatively managed patients comprised 41.7%. We found a high prevalence of anxiety (no symptoms 8.3%, borderline 45.8%, anxiety 45.8%) and depression (no symptoms 4.2%, borderline 25.0%, depression 70.8%) among the study population. Depression was more prevalent in the watchful waiting cohort (90%, n=18, vs. 57.1%, n=16; p=0.001). No difference in the prevalence of anxiety was found (35%, n=7 vs. 53.6%, n=15; p=0.242). 43.8%, n=21 patients indicated significant burden on DT. The proportion of distressed patients in the watchful waiting group was as high as 55.0%. The psychological burden did not decrease with time: 40.9% (n=9) of patients reported DT score ≥ 6, 52.2% (n=12) had depressive and 43.5% (n=10) anxiety symptoms 3 months after the interview.
Conclusion: Taken into account the small patient sample, the data show that the prevalence of psychological distress is high in non-operated meningioma patients. Both, patients under watchful waiting and after complete meningioma removal should be offered a psychooncological support.
