PURPOSE Few studies have assessed fatigue in relation to glioma surgery. The purpose of this study was to explore the prevalence of pre- and postoperative high fatigue, perioperative changes, and factors associated with pre- and postoperative high fatigue in patients undergoing primary surgery for diffuse glioma. METHODS A total of 112 adult patients were prospectively included. Patient-reported fatigue was assessed before and one month after surgery using the cancer-specific European Organization for Research and Treatment of Cancer questionnaire fatigue subscale. The scores were dichotomized as high fatigue (≥ 39) or low fatigue (< 39). A change in score of ≥ 10 was considered as a clinically significant change. Factors associated with pre- and postoperative high fatigue were explored in multivariable regression analyses. RESULTS High fatigue was reported by 45% of the patients preoperatively and by 42% of the patients postoperatively. Female gender and low Karnofsky Performance Status (KPS) were associated with preoperative high fatigue, while postoperative complications, low KPS and low-grade histopathology were associated with postoperative high fatigue. In total 35/92 (38%) patients reported a clinically significant improvement of fatigue scores after surgery, 36/92 (39%) patients reported a clinically significant worsening of fatigue scores after surgery, and 21/92 (23%) patients reported no clinically significant change in fatigue scores after surgery. Patients with low-grade gliomas more often reported low fatigue before surgery and high fatigue after surgery, while patients with high-grade gliomas more often reported high fatigue before surgery and low fatigue after surgery. CONCLUSIONS Our findings indicate that fatigue is a common symptom in patients with diffuse glioma, both pre- and postoperatively. Perioperative changes were frequently seen. This is important knowledge when informing patients before and after surgery.

中文翻译：

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弥漫性神经胶质瘤患者的围手术期疲劳。

目的很少有研究评估与神经胶质瘤手术有关的疲劳。这项研究的目的是探讨弥漫性神经胶质瘤的初次手术患者术前和术后高疲劳的发生率，围手术期变化以及与术前和术后高疲劳相关的因素。方法前瞻性纳入112例成年患者。使用癌症特定的欧洲癌症研究和治疗组织问卷调查疲劳量表，评估了患者报告的疲劳程度，分别在手术前后和术后一个月进行了评估。分数分为高疲劳（≥39）或低疲劳（<39）。得分≥10的变化被认为是临床上的重大变化。在多变量回归分析中探讨了与术前和术后高疲劳相关的因素。结果据报道，术前有45％的患者感到疲劳，术后有42％的患者感到疲劳。女性性别和低Karnofsky表现状态（KPS）与术前高疲劳有关，而术后并发症，低KPS和低度组织病理学与术后高疲劳有关。在总共35/92（38％）的患者中报告了手术后疲劳评分的临床显着改善； 36/92（39％）的患者在手术后报告了疲劳评分的临床显着恶化，而21/92（23％）的患者在手术后报告了手术后疲劳评分无临床显着变化。患有低度神经胶质瘤的患者更常报告手术前低疲劳和手术后高疲劳，患有高度神经胶质瘤的患者更常报告手术前高疲劳和手术后低疲劳。结论我们的发现表明，在弥漫性神经胶质瘤患者中，术前和术后疲劳都是常见症状。围手术期变化是常见的。这是在告知患者手术前后的重要知识。