TY - JOUR
T1 - Added Value of Cognition in the Prediction of Survival in Low and High Grade Glioma
AU - van Kessel, Emma
AU - Schuit, Ewoud
AU - Huenges Wajer, Irene M.C.
AU - Ruis, Carla
AU - De Vos, Filip Y.F.L.
AU - Verhoeff, Joost J.C.
AU - Seute, Tatjana
AU - van Zandvoort, Martine J.E.
AU - Robe, Pierre A.
AU - Snijders, Tom J.
N1 - Funding Information: This research was funded by Ton & Patricia Bohnenn Fund for Neuro-oncology. Publisher Copyright: Copyright © 2021 van Kessel, Schuit, Huenges Wajer, Ruis, De Vos, Verhoeff, Seute, van Zandvoort, Robe and Snijders.
PY - 2021/11/18
Y1 - 2021/11/18
N2 - Background: Diffuse gliomas, which are at WHO grade II-IV, are progressive primary brain tumors with great variability in prognosis. Our aim was to investigate whether pre-operative cognitive functioning is of added value in survival prediction in these patients. Methods: In a retrospective cohort study of patients undergoing awake craniotomy between 2010 and 2019 we performed pre-operative neuropsychological assessments in five cognitive domains. Their added prognostic value on top of known prognostic factors was assessed in two patient groups [low- (LGG) and high-grade gliomas (HGG]). We compared Cox proportional hazards regression models with and without the cognitive domain by means of loglikelihood ratios tests (LRT), discriminative performance measures (by AUC), and risk classification [by Integrated Discrimination Index (IDI)]. Results: We included 109 LGG and 145 HGG patients with a median survival time of 1,490 and 511 days, respectively. The domain memory had a significant added prognostic value in HGG as indicated by an LRT (p-value = 0.018). The cumulative AUC for HGG with memory included was.78 (SD = 0.017) and without cognition 0.77 (SD = 0.018), IDI was 0.043 (0.000–0.102). In LGG none of the cognitive domains added prognostic value. Conclusions: Our findings indicated that memory deficits, which were revealed with the neuropsychological examination, were of additional prognostic value in HGG to other well-known predictors of survival.
AB - Background: Diffuse gliomas, which are at WHO grade II-IV, are progressive primary brain tumors with great variability in prognosis. Our aim was to investigate whether pre-operative cognitive functioning is of added value in survival prediction in these patients. Methods: In a retrospective cohort study of patients undergoing awake craniotomy between 2010 and 2019 we performed pre-operative neuropsychological assessments in five cognitive domains. Their added prognostic value on top of known prognostic factors was assessed in two patient groups [low- (LGG) and high-grade gliomas (HGG]). We compared Cox proportional hazards regression models with and without the cognitive domain by means of loglikelihood ratios tests (LRT), discriminative performance measures (by AUC), and risk classification [by Integrated Discrimination Index (IDI)]. Results: We included 109 LGG and 145 HGG patients with a median survival time of 1,490 and 511 days, respectively. The domain memory had a significant added prognostic value in HGG as indicated by an LRT (p-value = 0.018). The cumulative AUC for HGG with memory included was.78 (SD = 0.017) and without cognition 0.77 (SD = 0.018), IDI was 0.043 (0.000–0.102). In LGG none of the cognitive domains added prognostic value. Conclusions: Our findings indicated that memory deficits, which were revealed with the neuropsychological examination, were of additional prognostic value in HGG to other well-known predictors of survival.
KW - added value
KW - cognition
KW - diffuse glioma
KW - prediction models
KW - prognosis
KW - survival
UR - http://www.scopus.com/inward/record.url?scp=85120691053&partnerID=8YFLogxK
U2 - https://doi.org/10.3389/fneur.2021.773908
DO - https://doi.org/10.3389/fneur.2021.773908
M3 - Article
SN - 1664-2295
VL - 12
JO - Frontiers in Neurology
JF - Frontiers in Neurology
M1 - 773908
ER -