Quality-of-life assessment in patients who had been surgically treated for cerebellar pilocytic astrocytoma in childhood

Alfredo Pompili Division of Neurosurgery, Service of Neurology, Epidemiology Unit, “Regina Elena” National Cancer Institute, Rome, Italy

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Marco Caperle Division of Neurosurgery, Service of Neurology, Epidemiology Unit, “Regina Elena” National Cancer Institute, Rome, Italy

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Andrea Pace Division of Neurosurgery, Service of Neurology, Epidemiology Unit, “Regina Elena” National Cancer Institute, Rome, Italy

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Valerio Ramazzotti Division of Neurosurgery, Service of Neurology, Epidemiology Unit, “Regina Elena” National Cancer Institute, Rome, Italy

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Laura Raus Division of Neurosurgery, Service of Neurology, Epidemiology Unit, “Regina Elena” National Cancer Institute, Rome, Italy

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Bruno Jandolo Division of Neurosurgery, Service of Neurology, Epidemiology Unit, “Regina Elena” National Cancer Institute, Rome, Italy

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Emanuele Occhipinti Division of Neurosurgery, Service of Neurology, Epidemiology Unit, “Regina Elena” National Cancer Institute, Rome, Italy

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Object. After radical surgery for childhood cerebellar astrocytomas, patients are considered to be cured. Long-term follow up demonstrates that these patients survive, with most of them leading a normal life. The study reported here was aimed at assessing the quality of life (QOL) of these adults, which is defined as a person's sense of well-being, as derived from his or her current experience of life as a whole.

Methods. Twenty patients who had undergone surgery between 1970 and 1985 were enrolled in the study. In four patients ventriculoperitoneal shunts were in place; two of these patients had required more than six shunt revisions. At present, all patients have clear neuroimaging studies and their Karnofsky Performance Scale (KPS) scores are as follows: 70 in three, 80 in seven, 90 in six, and 100 in four. A QOL questionnaire was administered to the patients and to a control group consisting of 20 healthy volunteers of matching age and sex. The chi-square test was applied to compare patients and controls. Traditional questions on the level of education, work, whether the patients have their own families, and whether they possessed a driver's license were asked at the end of the questionnaire.

In all the dimensions assessed except one (sex life), the difference between patients and control volunteers was significant, socializing and adolescence being the most striking ones. This was also true when the three patients with the lowest KPS scores and the worst QOL results were excluded.

Conclusions. By traditional standards, these patients appear to fare quite well. Nevertheless, their self-reported life experience is unsatisfying when compared with the control group. The authors conclude that psychosocial factors are critical to complete recovery and the QOL of children who undergo successful operations for benign cerebellar astrocytoma.

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