Depression and survival of glioma patients: A systematic review and meta-analysis.

Autor: Shi C; Computational Neurosciences Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA, United States; Harvard T.H. Chan School of Public Health, Boston, MA, United States., Lamba N; Computational Neurosciences Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States., Zheng LJ; CVS Health, Woonsocket, RI, United States., Cote D; Computational Neurosciences Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States., Regestein QR; Department of Psychiatry, Brigham and Women's Hospital, 1249 Boylston St., Boston, MA 02215, United States., Liu CM; Department of Pharmaceutical Business and Administrative Sciences MCPHS University, Boston, MA, United States., Tran Q; Department of Pharmaceutical Business and Administrative Sciences MCPHS University, Boston, MA, United States., Routh S; Department of Pharmaceutical Business and Administrative Sciences MCPHS University, Boston, MA, United States., Smith TR; Computational Neurosciences Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA, United States., Mekary RA; Computational Neurosciences Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA, United States; Department of Pharmaceutical Business and Administrative Sciences MCPHS University, Boston, MA, United States., Broekman MLD; Computational Neurosciences Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA, United States; Department of Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address: M.L.D.Broekman-4@umcutrecht.nl.
Jazyk: angličtina
Zdroj: Clinical neurology and neurosurgery [Clin Neurol Neurosurg] 2018 Sep; Vol. 172, pp. 8-19. Date of Electronic Publication: 2018 Jun 18.
DOI: 10.1016/j.clineuro.2018.06.016
Abstrakt: Introduction: There is currently a lack of a well-formed consensus regarding the effects of depression on the survival of glioma patients. A more thorough understanding of such effects may better highlight the importance of recognizing depressive symptoms in this patient population and guide treatment plans in the future.
Objective: The aim of this meta-analysis was to study the effect of depression on glioma patients' survival.
Methods: A meta-analysis was conducted according to the PRISMA guidelines. PubMed, Embase, and Cochrane databases were searched for studies that reported depression and survival among glioma patients through 11/06/2016. Both random-effects (RE) and fixed-effect (FE) models were used to compare survival outcomes in glioma patients with and without depression.
Results: Out of 619 identified articles, six were selected for the meta-analysis. Using RE model, the various measures for survival outcomes displayed worsened outcomes for both high and low-grade glioma patients with depression compared to those without depression. For binary survival outcomes, the overall pooled risk ratio for survival was 0.70 (95% CI: 0.47, 1.04; 6 studies; I 2  = 54.9%, P-heterogeneity = 0.05) for high grade gliomas (HGG) and 0.28 (95% CI: 0.04, 1.78; I 2  = 0%, P-heterogeneity = 1.00; one study) for low grade gliomas (LGG) was. A sub-group analysis in the HGG group by depression timing (pre- versus post-operative) revealed no differences between depression and survival outcomes (P-interaction = 0.47). For continuous survival outcomes, no statistically significant difference was found among the high and low-grade glioma groups (P-interaction = 0.31). The standardized mean difference (SMD) in survival outcomes was -0.56 months (95%CI: -1.13, 0.02; 4 studies, I 2  = 89.4%, P-heterogeneity < 0.01) for HGG and -1.69 months (95%CI: -3.26, -0.13; one study; I 2  = 0%, P-heterogeneity = 1.00) for LGG. In patients with HGG, the pooled HR of death also showed a borderline significant increased risk of death among depressive patients (HR 1.42, 95% CI: 1.00, 2.01). Results using the FE model were not materially different.
Conclusions: Depression was associated with significantly worsened survival regardless of time of diagnosis, especially among patients with high-grade glioma.
(Copyright © 2018 The Author(s). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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