Prognostic awareness, prognostic communication, and cognitive function in patients with malignant glioma.

Abstract:

Background:Malignant glioma (MG) is a devastating neuro-oncologic disease with almost invariably poor prognosis. Prognostic awareness (PA) is the awareness of incurable disease and shortened life expectancy (LE). Accurate PA is associated with favorable psychological outcomes at the end of life (EoL) for patients with cancer; however, little is known about PA or prognostic communication in MG. Moreover, research has yet to evaluate the impact of cognitive impairment on PA and preferred forms of communication. Methods:Fifty MG patients and 32 paired caregivers were evaluated in this exploratory study with a semi-structured PA assessment aimed to measure their awareness of MG incurability and LE. Full PA was defined as awareness of MG incurability and accurate estimate of LE. The assessment included a survey about preferences for prognostic communication (items from the Prognosis and Treatment Perceptions Questionnaire), neurocognitive assessment (Hopkins Verbal Learning Test-Revised, Trail Making Test Parts A and B, and the Controlled Oral Word Association Test), and measurements of mood (Hospital Anxiety and Depression Scale) and quality of life (Functional Assessment of Cancer Therapy-Brain [FACT-Br]). Results:Twenty (40%) patients and 22 (69%) caregivers had full PA. Thirty (60%) patients and 23 (72%) caregivers reported that prognostic information was extremely or very important, and 21 (42%) patients and 16 (50%) caregivers desired more prognostic information. Patients with memory impairment more frequently believed that prognostic information was important (P = 0.04, P = 0.03) and desired more information (P = 0.05, P = 0.003) as compared with those without impairment. Conclusions:Most MG patients were unaware of their LE. Memory impairment may influence preferences for prognostic information.

journal_name

Neuro Oncol

journal_title

Neuro-oncology

authors

Diamond EL,Prigerson HG,Correa DC,Reiner A,Panageas K,Kryza-Lacombe M,Buthorn J,Neil EC,Miller AM,DeAngelis LM,Applebaum AJ

doi

10.1093/neuonc/nox117

subject

Has Abstract

pub_date

2017-10-19 00:00:00

pages

1532-1541

issue

11

eissn

1522-8517

issn

1523-5866

pii

3884503

journal_volume

19

pub_type

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