A prospective evaluation of short-term health-related quality of life in patients undergoing anterior skull base surgery

Abstract

We evaluated the health-related quality of life (QOL) of patients undergoing anterior skull base tumor resection. The Anterior Skull Base Surgery QOL questionnaire, a disease-specific multidimensional instrument dedicated to this population, was used to collect and prospectively analyze demographic, medical, and QOL data on 48 patients. Thirty-nine patients completed the questionnaire preoperatively and at 6 and 12 months postoperatively. Seventeen patients (44%) had malignant histology and 22 (56%) had benign tumors. The overall QOL score decreased significantly at 6 months postoperatively (p < 0.05) and improved significantly at 12 months postoperatively (p < 0.04). The emotional domain improved significantly at 12 months postoperatively compared with the preoperative scores (p < 0.03). Patients with malignant tumors had lower scores at 6 months postoperatively compared with patients with benign lesions (p < 0.002), although the scores for both groups at 12 months postoperatively were similar. Adjuvant radiation therapy was associated with a poor QOL (p < 0.005). The results of this prospective study show that the overall deteriorated QOL of patients after anterior skull base tumor resection returns to baseline by 1 year after surgery. Histology and radiotherapy are significant predictors of health-related QOL in this population.

Keywords: Craniofacial resection; cancer; cranial base; subcranial approach.

Figure 1

Estimates of quality of life scores before and after anterior skull base tumor resections. There was a significant decrease in the overall scores at 6 months after surgery (p < 0.05) and a recovery to baseline at 1 year after surgery. Pre Op, preoperatively.

Figure 2

Quality of life (QOL) score in the emotional domain. (A) Overall QOL scores. (B) QOL scores in patients with benign tumors showing significant improvement between 6 and 12 months after surgery (p < 0.05). (C) QOL scores in patients with malignant tumors showing a decline in scores at 6 months after surgery and improvement at 12 months postoperatively (p < 0.005). Pre Op, preoperatively.

Figure 3

Impact of histology and prior surgery on quality of life (QOL) scores. (A) Malignant histology (open circles) was associated with lower overall QOL scores at 6 months after surgery, whereas patients with benign tumors (closed circles) had stable QOL scores (p < 0.005). (B) Prior skull base surgery had no significant impact on QOL scores (previous surgery, open circles). Pre Op, preoperatively.