Depression is the most common postoperative
complication seen in patients who have undergone surgery for brain
tumors, but it is seldom recognized or treated, according to
preliminary findings of a study presented at the annual meeting of
the American Association of Neurological Surgeons.
The study involved data on 285 patients enrolled at 54 clinical sites
in the United States and Canada who had undergone surgery for
high-grade glioma. Researchers found that while 34% of patients
reported experiencing at least 2 weeks of postoperative depression
during the previous year, physicians had diagnosed postoperative
depression in only 14%, and only 5% of those diagnosed (15 patients)
had received antidepressant medication.
Although a planned 2-year follow-up is still ongoing, These
preliminary findings demonstrate the magnitude of the problem of
postoperative depression in glioma patients, said Frederick A.
Anderson, Jr.,PhD, director of the Center for Outcomes Research and
coauthor of the study with N. Scott Litofsky, MD, FACS, associate
professor of surgery in the Division of Neurosurgery, both at the
University of Massachusetts Medical School in Worcester. These
observations should help physicians become more aware of the symptoms
of depression in their patients.
Project to Track Trends in Glioma Care
The study is the first research to emerge from the Glioma Outcomes
(GO) Project. The goal of this North American database is to provide
data useful for the evaluation and improvement of care of patients
Patient accrual in the GO Project began in November 1997, and the
database is being coordinated by the Center for Outcomes Research at
the University of Massachusetts Medical School. The project is being
underwritten by an educational grant from Rhone-Poulenc Rorer
The GO Project is designed to track trends in patient characteristics
and glioma care, including natural history, risk factors, diagnostic
approach, resource utilization, and treatment methods. Participating
neurosurgeons report data on their glioma patients at surgery and at
3-month intervals for up to 2 years. Patients, who provide written
informed consent, complete questionnaires regarding their functional
status and satisfaction with care at similar intervals. The central
data coordinating center summarizes and analyzes the data and sends
regular reports to neurosurgeons.
Quality of life issues for glioma patients are rarely
addressed, said Dr. Anderson. The Glioma Outcomes Project
will provide physicians with benchmark data that will allow them to
compare their individual practice patterns and outcomes with the
experience of their peers in caring for comparable patients, and
identify opportunities to improve quality of care for those patients.