Association of postoperative anxiety and depressive symptom severity with progression-free survival in IDH-wild-type glioblastoma
- 1Department of Neurosurgery, The First Affiliated Hospital of Wannan Medical University
- 2Institutes of Brain Science, Wannan Medical University
- 3Department of Neurology, The First Affiliated Hospital of Wannan Medical University
Abstract
Background: Anxiety and depressive symptoms are common in patients with glioblastoma, but their association with progression-free survival (PFS) remains incompletely characterized in molecularly defined populations. We examined these associations in patients with IDH-wild-type glioblastoma.
Methods: This single-center observational study included 64 adults with newly diagnosed IDH-wild-type glioblastoma who completed the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) at a median of 35 days after resection (range, 30–38 days), before postoperative adjuvant therapy. Scores ≥10 defined positive screens. Separate multivariable Cox models estimated associations with PFS, adjusting for age, Karnofsky Performance Status, and gross-total resection. An independent exploratory analysis compared neurotransmitter- and stress-related receptor expression in paired primary and recurrent tumors from 105 patients annotated as having IDH-wild-type glioblastoma in the Glioma Longitudinal Analysis Consortium (GLASS).
Results: Compared with scores below the respective screening thresholds, greater anxiety symptom burden [GAD-7 score ≥10; adjusted hazard ratio 1.92, 95% confidence interval (CI) 1.08–3.42] and greater depressive symptom burden (PHQ-9 score ≥10; adjusted hazard ratio 4.22, 95% CI 1.72–10.35) were associated with shorter PFS. Supportive continuous-score analyses showed consistent associations. In the independent GLASS cohort, recurrent tumors showed higher adrenergic, serotonergic, dopaminergic, and GABAergic receptor-family scores, higher CRHR1 expression, and lower AVPR1A expression.
Conclusion: Greater postoperative anxiety and depressive symptom burden was associated with shorter PFS in IDH-wild-type glioblastoma. Prospective studies with repeated symptom assessments, more complete clinical data, and matched molecular sampling are needed to evaluate these observational associations and the separate, hypothesis-generating molecular findings.
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BibTeX
@article{xiong2026association,
title = {{Association of postoperative anxiety and depressive symptom severity with progression-free survival in IDH-wild-type glioblastoma}},
author = {Zhang Xiong and Zixiao Li and Changli Han and Xiangxiang Peng},
journal = {Frontiers in Oncology},
year = {2026},
month = oct,
doi = {10.3389/fonc.2026.1949803},
url = {https://www.frontiersin.org/articles/10.3389/fonc.2026.1949803/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Association of postoperative anxiety and depressive symptom severity with progression-free survival in IDH-wild-type glioblastoma
AU - Zhang Xiong
AU - Zixiao Li
AU - Changli Han
AU - Xiangxiang Peng
PY - 2026
DA - 2026/10/19
JO - Frontiers in Oncology
DO - 10.3389/fonc.2026.1949803
UR - https://www.frontiersin.org/articles/10.3389/fonc.2026.1949803/full
AB - Background: Anxiety and depressive symptoms are common in patients with glioblastoma, but their association with progression-free survival (PFS) remains incompletely characterized in molecularly defined populations. We examined these associations in patients with IDH-wild-type glioblastoma. Methods: This single-center observational study included 64 adults with newly diagnosed IDH-wild-type glioblastoma who completed the Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) at a median of 35 days after resection (range, 30–38 days), before postoperative adjuvant therapy. Scores ≥10 defined positive screens. Separate multivariable Cox models estimated associations with PFS, adjusting for age, Karnofsky Performance Status, and gross-total resection. An independent exploratory analysis compared neurotransmitter- and stress-related receptor expression in paired primary and recurrent tumors from 105 patients annotated as having IDH-wild-type glioblastoma in the Glioma Longitudinal Analysis Consortium (GLASS). Results: Compared with scores below the respective screening thresholds, greater anxiety symptom burden [GAD-7 score ≥10; adjusted hazard ratio 1.92, 95% confidence interval (CI) 1.08–3.42] and greater depressive symptom burden (PHQ-9 score ≥10; adjusted hazard ratio 4.22, 95% CI 1.72–10.35) were associated with shorter PFS. Supportive continuous-score analyses showed consistent associations. In the independent GLASS cohort, recurrent tumors showed higher adrenergic, serotonergic, dopaminergic, and GABAergic receptor-family scores, higher CRHR1 expression, and lower AVPR1A expression. Conclusion: Greater postoperative anxiety and depressive symptom burden was associated with shorter PFS in IDH-wild-type glioblastoma. Prospective studies with repeated symptom assessments, more complete clinical data, and matched molecular sampling are needed to evaluate these observational associations and the separate, hypothesis-generating molecular findings.
SN - 2234-943X
ER -