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dc.contributor.authorJakola, Asgeir S
dc.contributor.authorGulati, Sasha
dc.contributor.authorWeber, Clemens
dc.contributor.authorUnsgård, Geirmund
dc.contributor.authorSolheim, Ole
dc.date.accessioned2015-10-30T11:16:26Z
dc.date.accessioned2015-11-26T12:40:56Z
dc.date.available2015-10-30T11:16:26Z
dc.date.available2015-11-26T12:40:56Z
dc.date.issued2011
dc.identifier.citationPLoS ONE 2011, 6(12)nb_NO
dc.identifier.issn1932-6203
dc.identifier.urihttp://hdl.handle.net/11250/2365868
dc.description.abstractBackground: Studies indicate that acquired deficits negatively affect patients' self-reported health related quality of life (HRQOL) and survival, but the impact of HRQOL deterioration after surgery on survival has not been explored. Objective: Assess if change in HRQOL after surgery is a predictor for survival in patients with glioblastoma. Methods: Sixty-one patients with glioblastoma were included. The majority of patients (n = 56, 91.8%) were operated using a neuronavigation system which utilizes 3D preoperative MRI and updated intraoperative 3D ultrasound volumes to guide resection. HRQOL was assessed using EuroQol 5D (EQ-5D), a generic instrument. HRQOL data were collected 1–3 days preoperatively and after 6 weeks. The mean change in EQ-5D index was −0.05 (95% CI −0.15–0.05) 6 weeks after surgery (p = 0.285). There were 30 patients (49.2%) reporting deterioration 6 weeks after surgery. In a Cox multivariate survival analysis we evaluated deterioration in HRQOL after surgery together with established risk factors (age, preoperative condition, radiotherapy, temozolomide and extent of resection). Results: There were significant independent associations between survival and use of temozolomide (HR 0.30, p = 0.019), radiotherapy (HR 0.26, p = 0.030), and deterioration in HRQOL after surgery (HR 2.02, p = 0.045). Inclusion of surgically acquired deficits in the model did not alter the conclusion. Conclusion: Early deterioration in HRQOL after surgery is independently and markedly associated with impaired survival in patients with glioblastoma. Deterioration in patient reported HRQOL after surgery is a meaningful outcome in surgical neuro-oncology, as the measure reflects both the burden of symptoms and treatment hazards and is linked to overall survival.nb_NO
dc.language.isoengnb_NO
dc.publisherPublic Library of Sciencenb_NO
dc.titlePostoperative deterioration in health related quality of life as predictor for survival in patients with glioblastoma: a prospective studynb_NO
dc.typeJournal articlenb_NO
dc.typePeer revieweden_GB
dc.date.updated2015-10-30T11:16:26Z
dc.source.volume6nb_NO
dc.source.journalPLoS ONEnb_NO
dc.source.issue12nb_NO
dc.identifier.doi10.1371/journal.pone.0028592
dc.identifier.cristin880369
dc.description.localcode© 2011 Jakola et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.nb_NO


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