Patient reported feasibility and acceptance of Montreal Cognitive Assessment (MoCA) screening pre- and postoperatively in brain tumour patients.

BACKGROUND: Montreal Cognitive Assessment (MoCA) represents a short screening tool for neuropsychological deficits. The study's aim was to test feasibility and acceptance of MoCA in patients with brain tumours perioperatively. METHODS: Patients with supratentorial located brain tumours were assessed preoperatively (t1, day -1) and postoperatively (t2, day 3-5) using EORTC-QLQ-C30 + BN20, Distress Thermometer (DT) and the MoCA test (different versions). Feasibility was evaluated by a feedback form and patients were asked about perceived discomfort, overstraining or complexity of MoCA. Results of MoCA were correlated with clinical factors. RESULTS: 63 patients participated, 19 were male. Mean age was 56 years. Mean completion time of MoCA was 11 min (both t1 and t2). At t1, in 27% "moderate or major difficulties" occurred during MoCA assessment vs. 41% at t2. Most of the patients (t1, 93% vs. t2, 86%) negated to be overstrained by MoCA. Better "physical function" according to EORTC-QLQ-C30 (p = 0.041, Pearson = 0.321) and higher KPS (p = 0.012, Pearson = 0.578) correlated to higher MoCA scores. Higher distress at t2 was found to be correlated with a stronger deterioration of MoCA at t2 vs. t1 (p = 0.03, Spearman-Rho = .695). CONCLUSION: The MoCA test was well accepted by the patients and implementable in clinical routine. Further investigations evaluating the sensitivity and specificity of the test in brain tumour patients are required.

Evaluating patients for psychosocial distress and supportive care needs based on health-related quality of life in primary brain tumors: a prospective multicenter analysis of patients with gliomas in an outpatient setting.

The association between health-related quality of life (HRQoL), psychosocial distress, and supportive care is in the focus of patient-centered neuro-oncology. We investigated the relationship between the aforementioned in glioma-patients to evaluate the association of these instruments and determine cut-off values for suitable HRQoL scales indicating a potential need for intervention. In an observational multi-center study, outpatients completed the Distress Thermometer (DT), EORTC Quality of Life Questionnaire (EORTC-QLQ-C30/BN20, HRQoL), and Supportive-Care-Needs-Survey-SF34-G (SCNS). Based on nine EORTC-function and selected -symptom scales items of the questionnaires were matched. Convergent validity of related single items and scores across the instruments was estimated. EORTC cut-off values were calculated. Data of 167 patients were analyzed. The strongest correlation of EORTC-QLQ-C30 and DT was found for cognitive function (cogf), global health status (GHS), emotional (emof), role function (rolef), future uncertainty (FU), fatigue, and between EORTC-QLQ-C30 and SCNS for FU, emof, rolef (r = |0.4-0.7|; p < 0.01). EORTC cut-off values of <54.2 (GHS/QoL) and <62.5 (emof) predicted a DT ≥ 6 (AUC 0.79, 0.85, p < 0.01). EORTC cut-off values of <70.8 (emof) and <52.8 (FU) predicted the need for supportive care (AUC 0.78, 0.85; p < 0.01). Worse EORTC-C30 scores correlate with higher DT and SCNS scores. With this exploratory assessment, cut-off values for EORTC-C30 subscores to predict distress and pathological SCNS-scores could be determined, which could influence patients' referral to further treatment. However, further prospective clinical trials are needed to confirm the clinical relevance of these cut-off values.