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. 2024 Nov 28:14:1463467.
doi: 10.3389/fonc.2024.1463467. eCollection 2024.

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

Tommaso Araceli  1   2 , Anna Fischl  2   3 , Amer Haj  1   2 , Christian Doenitz  1   2 , Eva-Maria Stoerr  1 , Andrea Hillberg  2   4 , Martin Vogelhuber  2   4 , Katharina Rosengarth  1   2 , Markus J Riemenschneider  2   5 , Peter Hau  2   3 , Raquel Blazquez  4   6 , Tobias Pukrop  2   4   6 , Elisabeth Bumes  2   3 , Nils Ole Schmidt  1   2 , Martin Proescholdt  1   2
Affiliations

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

Tommaso Araceli et al. Front Oncol. .

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.

Keywords: brain tumor; neurosurgery; psycho-oncological need; psycho-oncology; psychological distress.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Pie charts showing part of baseline data.
Figure 2
Figure 2
Graphs illustrating the significant influence of age and presurgical KPS on questionnaire completion.
Figure 3
Figure 3
Influence of presurgical KPS on psycho-oncological burden.
Figure 4
Figure 4
Multivariate binary logistic regression analysis of psycho-oncological need, showing the odds ratios of the impact of clinical characteristics in relation to psycho-oncological burden.
See this image and copyright information in PMC

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