Introduction
Materials and methods
Patients
Study procedure and design
Measures
Sociodemographic and clinical measures
Neuropsychological assessment
MRI-cerebrum and time until PD
Cognitive change as a personalized predictor
Reliable change
Personalized selection and criterion for cognitive decline (CD)
Statistical analyses
Results
Patients
Characteristic | N = 25 |
---|---|
Male n (%) | 17 (68%) |
Age at time of surgery (M ± SD, range) | 53 ± 14, 19–76 |
Educational levela | |
Low n (%) | 3 (12%) |
Middle n (%) | 12 (48%) |
High n (%) | 10 (40%) |
Diagnosis | |
Glioblastoma | 21 (84%) |
Anaplastic astrocytoma | 4 (16%) |
Tumor volume (cm3), median (range) | 37 (4.4–162) |
KPS before surgery, mode (range) | 90, 80–100 |
Tumor lateralization n (%) | |
Right | 15 (60%) |
Left | 10 (40%) |
Tumor location n (%) | |
Frontal | 6 (24%) |
Fronto–parietal | 1 (4%) |
Parietal | 3 (12%) |
Parieto–temporal | 2 (8%) |
Parieto–occipital | 4 (16%) |
Temporal | 3 (12%) |
Occipital | 6 (24%) |
Corticosteroids before surgery | 17 (68%) |
Anti-epileptics before surgery | 8 (32%) |
Macroscopic extent of resection | |
Gross total resection ( > 90%) | 17 (68%) |
Gross subtotal resection ( < 90%) | 8 (31%) |
Diagnosis | Age | Location | Hemisphere | Selected tests | Impairment on selected tests at T0a | PD during follow up |
---|---|---|---|---|---|---|
GBM | 18–20 | Frontal | Left | SAT, LF, SDC | 3/3 | Noc |
GBM | 60–70 | Parieto–occipital | Right | SAT, VEM, SDC | 2/3 | Yes |
AA | 30–40 | Frontal | Left | DSFW, LF, SAT | 1/3 | Noc |
GBM | 60–70 | Occipital | Left | VIM, DSB, DSF | 0/3 | Yes |
GBM | 50–60 | Occipital | Right | SDC, CPT, FTT | 2/3 | Yes |
GBM | 50–60 | Fronto–parietal | Right | SAT, VIM, VEM | 1/3 | Yes |
GBM | 40–50 | Frontal | Right | SAT, CPT, FTT | 2/3 | Yes |
GBM | 60–70 | Parietal | Right | CPT, SAT, VEM | 3/3 | Yes |
GBM | 60–70 | Occipital | Right | VIM, SAT, VEM | 3/3 | Yes |
GBM | 40–50 | Frontal | Left | FTT, CPT, SAT | 0/3 | Yes |
GBM | 50–60 | Parieto–occipital | Left | SAT, CPT, SDC | 1/3 | Nob |
GBM | 50–60 | Parietal | Left | SAT, VIM, FTT | 3/3 | Yes |
GBM | 50–60 | Parieto–occipital | Right | FTT, CPT, SDC | 3/3 | Nob |
AA | 30–40 | Frontal | Right | VIM, VEM, LF | 0/3 | Noc |
GBM | 60–70 | Temporo–parietal | Left | FTT, SAT, Stroop | 0/3 | Yes |
GBM | 70–80 | Parietal | Right | FTT, SAT, Stroop | 2/3 | Yes |
GBM | 50–60 | Frontal | Right | FTT, VIM, DSF | 0/3 | Yes |
GBM | 50–60 | Occipital | Right | VEM, VIM, LF | 2/3 | Yes |
GBM | 50–60 | Temporo–parietal | Left | FTT, VEM, Stroop | 0/3 | Yes |
GBM | 30–40 | Occipital | Right | FTT, DSF, SDC | 2/3 | Nob |
GBM | 70–80 | Temporal | Right | Stroop, SAT, VIM | 0/3 | Yes |
GBM | 50–60 | Occipital | Right | VIM, Stroop, FTT | 1/3 | Noa |
GBM | 50–60 | Mesiotemporal | Left | FTT, LF, SDC | 3/3 | Noa |
AA | 50–60 | Temporal | Right | SAT, SDC, DSB | 3/3 | Noa |
AA | 20–30 | Parieto–occipital | Left | FTT, VEM, DSB | 2/3 | Noa |
Progressive disease (n = 15) | Decline on tests (n = 9) | Stable on tests (n = 6) |
---|---|---|
Age before surgery | 60.0 ± 7.6 | 58.3 ± 10.7 |
Low education | 0 (0%) | 1 (16.7%) |
High education | 4 (44.4%) | 3 (50%) |
Male | 7 (77.8%) | 5 (83.3%) |
Impairment on ≥ 1 selected test at T0 | 5 (55.6%) | 5 (83.3%) |
Tumor in left hemisphere | 4 (44.4%) | 1 (16,7%) |
Macroscopic total resection | 6 (66.7%) | 3 (50%) |
Time to CD (median) | T6 | n/a |
Time to PD (median) | T6 | T12 |
KPS < 90 at time of PD | 5 (55.6%) | 0 (0%) |
AEDs at time of PD (%, n at T3) | 6 (66.7%, 4) | 1 (16.7%, 1) |
Corticosteroids at time of PD | 2 (22.2%) | 0 (0%) |
RANO evaluation | ||
New contrast-enhancing lesion outside radiation fielda | 0 (0%) | 1 (16.7%) |
Increase ≥ 25% in the sum of the products of perpendicular diameters | 5 (55.6%) | 3 (50%) |
Clinical deterioration not attributable to medication or comorbidity ( ≥ 12 weeks post-chemoradiation) | 1 (11.1%) | 0 (0%) |
Significant increase in T2/FLAIR non-enhancing lesion | 0 (0%) | 0 (0%) |
Clear progression of a nonmeasurable lesion | 3 (33.3%) | 2 (33.3%) |
Stable disease (n = 10) | Decline on tests (n = 2) | Stable on tests (n = 8) |
---|---|---|
Age before surgery | 55.5 ± 3.54 | 40.3 ± 15.6 |
Low education | 0 (0%) | 2 (25%) |
High education | 1 (50%) | 4 (50%) |
Male | 2 (100%) | 3 (37.5%) |
Impairment on ≥ 1 selected test at T0 | 2 (100%) | 7 (87.5%) |
Tumor in left hemisphere | 1 (50%) | 4 (50%) |
Macroscopic total resection | 2 (100%) | 6 (75%) |
Time to CD (Median) | T6 | n/a |
Time to PD (Median) | n/a | n/a |
KPS < 90 at time of censoring | 0 (0%) | 0 (0%) |
AEDs at time of censoring (%, n at T3) | 0 (0%, 0) | 2 (25%, 2) |
Corticosteroids at time of censoring | 0 (0%) | 0 (0%) |