Διακρατικό ΠΜΣ Κλινική Νευροψυχολογία-Νοητικές Νευροεπιστήμες
Library of the School of Health Sciences

2018-07-06

2018

Dimitrakopoulou Paraskevi

Ιωάννης Ζαλώνης, Αν. Καθηγητής, Ιατρική, ΕΚΠΑ
Κώστας Πόταγας, Αν. Καθηγητής, Ιατρική, ΕΚΠΑ
Ιωάννης Ευδοκιμίδης, Ομ. Καθηγητής, Ιατρική, ΕΚΠΑ

Κλινικοαπεικονιστικές συσχετίσεις νεοδιαγνωσθέντων πρωτοπαθών όγκων κεντρικού νευρικού συστήματος και η επίδρασή τους στην επιβίωση ελεύθερη υποτροπής και την συνολική επιβίωση

Greek

Neurocognitive impairment is observed in patients with primary brain tumors. Cognitive impairment assessed by specific neuropsychology tests is independently associated with poor prognosis in patients with newly diagnosed glioma.

OBJECTIVE: The aim of this study was to demonstrate pre-operatively the clinical relevance between MMSE test performance and verbal fluency with clinical and imaging parameters in patients with primary CNS neoplasms and to correlate the performance of patients with (i) progression-free survival of the disease (free of relapse); (ii) overall survival.

SAMPLE AND METHODOLOGY: Our study sample consists of 100 patients with primary neoplasm of the central nervous system, 55 men and 45 women, with average age 48.77 ± 16.44 years and average education time-span 11.82 ± 3.75 years. The aforementioned patients were hospitalized at the Neurosurgery Clinic of the "Evaggelismos" General Hospital between 2014 and 2018, where surgical abscission of the CNS neoplasm was performed. Pre-operatively, neuropsychological tests of mental functions with the Mini Mental State Examination (MMSE) and verbal fluency (semantic & phonemic) tests were performed as a part of the standard protocol.

RESULTS: Comparing the pre-operative performance of patients in the MMSE, VFTsemantic and VFTphonemic between Low (Stages I, II) versus High (Stages III, IV) neoplasms, it was found that patients with High Grade neoplasms showed lower performance in the neuropsychological MMSE and VF. In all patients a significant negative correlation was found between VFTsemantic scores with the grade of glioma (p = -0.588, p <0.0001). The verbal fluency was not associated with a lobe but with the glioma stage (gravity).
The comparison groups I. MMSE < 24 vs. MMSE ≥ 24 and II. VFTsemantic Z-score < 1.5 vs. VFTsemantic Z-score ≥1.5 showed statistically significant differences in mean survival time (p-value = 0.016 and p-value = 0.046 respectively) and mean progression free survival (p-value = 0.000039 and p-value = 0.011 respectively). The multivariate Cox model with input variables, the MMSE test, the VFTsemantic Z-score, the degree of the grade, the type of surgery (total excerpt, partial dissection, biopsy) and age, showed MMSE as an independent prognostic survival factor [HR = 0.847 (95% CI: 0.740-0.968), p = 0.015] and as independent prognostic progression free survival factor [HR = 0.738 (95% CI: 0.612-0.891), p = 0.002].


CONCLUSIONS: The results of this study demonstrate the importance of cognitive assessment as a helpful prognostic index for monitoring the course of the disease in terms of future survival and the possibility of recurrence.

Health Sciences

Primary CNS neoplasms, Neuropsychological assessment, Progression free survival, Overall survival.

No

0

Yes

49

30

File access is restricted only to the intranet of UoA.

https://pergamos.lib.uoa.gr/uoa/dl/object/2777360