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Journal of Neuro-Oncology

, Volume 141, Issue 1, pp 167–182 | Cite as

Effects of surgery on neurocognitive function in patients with glioma: a meta-analysis of immediate post-operative and long-term follow-up neurocognitive outcomes

  • Justin Choon Hwee Ng
  • Angela An Qi See
  • Ting Yao Ang
  • Lysia Yan Rong Tan
  • Beng Ti Ang
  • Nicolas Kon Kam KingEmail author
Clinical Study

Abstract

Purpose

This study aims to identify the neuropsychological tests commonly used for assessment in each neurocognitive domain, and quantify the post-operative changes in neurocognitive function in the immediate post-operation and follow-up.

Methods

With the use of the PubMed, a comprehensive search of the English literature was performed following PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. There were 1021 publications identified for screening. Standardized mean differences (SMD) in neuropsychological task performance were calculated both for immediate post-operation (up to 1 week) and follow-up (up to 6 months).

Results

Out of 12 studies which met the inclusion criteria, 11 studies were analyzed in this meta-analysis, with a total of 313 patients (age range 18–82, 50% males) with intracranial gliomas (45% high-grade, 55% low-grade). Complex attention, language and executive function were the most frequently tested neurocognitive domains. Surgery had a positive impact in the domains of complex attention, language, learning and memory tasks in the immediate post-operative period and sustained improvement at follow-up. In contrast, surgery was found to negatively impact performance for executive function in the immediate post-operative period with sustained decline in performance in the long term.

Conclusions

This meta-analysis suggests that surgery for glioma confers a benefit for the domains of complex attention, language, learning and memory, while negatively affecting executive function, in the periods immediately after surgery and at 6 months follow-up. In addition, awake surgery seemed to confer a beneficial effect on neurocognitive functions. Future research should attempt to standardize a battery of neuropsychological tests for patients undergoing surgical resection for glioma, perhaps with a particular focus on executive function.

Keywords

Glioma Surgical resection Neurocognitive function Adult Meta-analysis 

Notes

Funding

This research is supported by Singapore Ministry of Health’s National Medical Research Council under its Translational and Clinical Research Flagship Programme - Tier 1 (Project No: NMRC/TCR/016-NNI/2016).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors. For this type of study formal consent is not required.

Supplementary material

11060_2018_3023_MOESM1_ESM.docx (16 kb)
Supplementary material 1 (DOCX 16 KB)
11060_2018_3023_MOESM2_ESM.docx (18 kb)
Supplementary material 2 (DOCX 19 KB)

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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
  2. 2.Department of NeurosurgerySingapore General HospitalSingaporeSingapore
  3. 3.Department of NeurosurgeryNational Neuroscience InstituteSingaporeSingapore
  4. 4.Duke-NUS Medical SchoolSingaporeSingapore

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