Prognostic awareness, prognostic communication, and cognitive function in patients with malignant glioma Journal Article


Authors: Diamond, E. L.; Prigerson, H. G.; Correa, D. C.; Reiner, A.; Panageas, K.; Kryza-Lacombe, M.; Buthorn, J.; Neil, E. C.; Miller, A. M.; DeAngelis, L. M.; Applebaum, A. J.
Article Title: Prognostic awareness, prognostic communication, and cognitive function in patients with malignant glioma
Abstract: Background. Malignant glioma (MG) is a devastating neuro-oncologic disease with almost invariably poor prognosis. Prognostic awareness (PA) is the awareness of incurable disease and shortened life expectancy (LE). Accurate PA is associated with favorable psychological outcomes at the end of life (EoL) for patients with cancer; however, little is known about PA or prognostic communication in MG. Moreover, research has yet to evaluate the impact of cognitive impairment on PA and preferred forms of communication. Methods. Fifty MG patients and 32 paired caregivers were evaluated in this exploratory study with a semi-structured PA assessment aimed to measure their awareness of MG incurability and LE. Full PA was defined as awareness of MG incurability and accurate estimate of LE. The assessment included a survey about preferences for prognostic communication (items from the Prognosis and Treatment Perceptions Questionnaire), neurocognitive assessment (Hopkins Verbal Learning Test-Revised, Trail Making Test Parts A and B, and the Controlled Oral Word Association Test), and measurements of mood (Hospital Anxiety and Depression Scale) and quality of life (Functional Assessment of Cancer Therapy-Brain [FACT-Br]). Results. Twenty (40%) patients and 22 (69%) caregivers had full PA. Thirty (60%) patients and 23 (72%) caregivers reported that prognostic information was extremely or very important, and 21 (42%) patients and 16 (50%) caregivers desired more prognostic information. Patients with memory impairment more frequently believed that prognostic information was important (P = 0.04, P = 0.03) and desired more information (P = 0.05, P = 0.003) as compared with those without impairment. Conclusions. Most MG patients were unaware of their LE. Memory impairment may influence preferences for prognostic information. © 2017.The Author(s).
Keywords: adult; clinical article; controlled study; aged; functional assessment; cancer patient; quality of life; health survey; patient assessment; questionnaire; depression; disease severity; medical information; glioblastoma; communication; interpersonal communication; attitude to illness; caregiver; cognitive defect; anxiety; memory disorder; awareness; life expectancy; semi structured interview; hospital anxiety and depression scale; end of life; clinical assessment tool; exploratory research; hopkins verbal learning test revised; parental attitude; cancer prognosis; measurement accuracy; human; male; female; article; malignant brain tumor; quality of lifez; controlled oral word association test; functional assessment of cancer therapy brain; prognosis and treatment perceptions questionnaire; trail making test parts a; trail making test parts b
Journal Title: Neuro-Oncology
Volume: 19
Issue: 11
ISSN: 1522-8517
Publisher: Oxford University Press  
Date Published: 2017-10-19
Start Page: 1532
End Page: 1541
Language: English
DOI: 10.1093/neuonc/nox117
PROVIDER: scopus
PUBMED: 28645200
PMCID: PMC5737692
DOI/URL:
Notes: Denise Correa's middle initial was misspelled in the original publication -- Article -- Export Date: 4 December 2017 -- Source: Scopus
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MSK Authors
  1. Anne S Reiner
    251 Reiner
  2. Denise D Correa
    83 Correa
  3. Katherine S Panageas
    517 Panageas
  4. Allison Joyce Applebaum
    191 Applebaum
  5. Eli Louis Diamond
    205 Diamond
  6. Alexandra Miller
    75 Miller
  7. Justin J Buthorn
    22 Buthorn