Psycho-oncological burden in patients with brain metastases undergoing neurological surgery

URN to cite this document:: urn:nbn:de:bvb:355-epub-746085
DOI to cite this document:: 10.5283/epub.74608

Araceli, Tommaso ; Fischl, Anna ; Haj, Amer ; Doenitz, Christian ; Stoerr, Eva-Maria ; Hillberg, Andrea ; Vogelhuber, Martin ; Rosengarth, Katharina

; Riemenschneider, Markus J.

; Hau, Peter

; Blazquez, Raquel ; Pukrop, Tobias

; Bumes, Elisabeth

; Schmidt, Nils Ole

; Proescholdt, Martin A.

License: Creative Commons Attribution 4.0
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Date of publication of this fulltext: 09 Jan 2025 16:41

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Abstract

Abstract

Purpose: The development of brain metastases (BM) can significantly increase the psycho-oncological burden in cancer patients, requiring timely intervention. In addition, this aspect may negatively affect the course of the disease and treatment outcome. However, screening for psycho-oncological burden is often overlooked in clinical routine. Therefore, we analyzed the extent of psycho-oncological distress in a patient population with BM receiving neurosurgical resection and identified clinical characteristics associated with a high need for psycho-oncological intervention.

Methods: We prospectively screened 353 patients (169 female, 184 male, mean age 61.9 years) scheduled for microsurgical resection of one or more BM. Psycho-oncological screening was performed on the day of admission using the Hornheider screening instrument (HSI) and the distress thermometer (DT). Screening results were correlated with demographic and clinical data.

Results: Most patients (73.1%) completed the screening questionnaire. Patients who failed to complete the questionnaire presented more frequently with metachronous BM (74.7% vs. 25.3%, p=0.009), were significantly older (p=0.0018), and had a significantly lower KPS score (p=0.0002). Based on the threshold values of the questionnaires, 59.3% of the patients showed a significant psycho-oncological burden requiring immediate intervention. Univariate analysis demonstrated that synchronous BM (p=0.034), tumors in eloquent areas (p=0.001), lower KPS (p=0.031), female gender (p=0.009), and presurgical aphasia (p=0.042) were significantly associated with high psycho-oncological burden. Multivariate analysis showed synchronous BM (p=0.045), female gender (p=0.005), and lower KPS (p=0.028) as independent factors associated with high psycho-oncological burden.

Conclusion: The majority of patients with BM have a high psycho-oncological burden. Female gender, synchronous BM, and lower KPS are independently associated with a need for psycho-oncological intervention.

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