Artikel
Return to work after awake surgery for gliomas in eloquent areas
Rückkehr in das Berufsleben nach Resektion eloquent gelegener Gliome unter Wachbedingungen
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Autoren
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Marie-Thérèse Forster
- Goethe Universität Frankfurt, Klinik für Neurochirurgie, Frankfurt am Main, Deutschland
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Irina Lortz
- Goethe Universität Frankfurt, Klinik für Neurochirurgie, Frankfurt am Main, Deutschland
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Volker Seifert
- Goethe Universität Frankfurt, Klinik für Neurochirurgie, Frankfurt am Main, Deutschland
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Christian Senft
- Goethe Universität Frankfurt, Klinik für Neurochirurgie, Frankfurt am Main, Deutschland
| Veröffentlicht: | 8. Mai 2019 |
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Gliederung
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Objective: Besides health and a fulfilled social life pursuing a profession is crucial for human happiness. The aim of this study was to analyse patients’ professional, socio-economic and psychological outcome besides their neuro-oncological and functional evaluation after awake surgery for gliomas in eloquent areas.
Methods: The neuro-oncological and functional outcome of 37 patients who underwent awake surgery for gliomas WHO grade I-III (22 astrocytomas, 13 oligodendrogliomas, 3 others; 3 WHO Grade I, 6 WHO grade II, 28 WHO grade III) during a period of 5 years was prospectively assessed within the routine oncological follow-up. Repercussions of the disease on their professional status, socio-economic situation, and neuro-cognitive function were evaluated retrospectively.
Results: Gross total and subtotal tumour resection was performed in 20 (54.1%) and 11 (29.7%) patients, respectively, whereas in 7 patients (16.2%) resection had to remain partial. Median follow up was 24.1 months (range: 5–61 months). 31 patients (83.8%) had stable disease, 2 (5.4%) patients suffered from tumour progression and 4 (10.8%) patients have died.
Prior to surgery all but one patient had a regular employment. At the time of analysis, 24 (72.7%) of 33 alive patients had resumed their profession. Median time for return to work after surgery was 5.9±4.6. 5 patients (15.2%) lived on incapacity pension, 2 patients had retired and 2 patients were on sick leave. Age <40 years was statistically significantly associated with return to work (p<0.001), while tumor histology or WHO grade were not (p=1.0, and p=0.11, respectively).
Conclusion: Despite brain tumour surgery in eloquent regions a large proportion of patients with WHO grade II or III gliomas are able to return to work. Employing awake surgery in order to preserve patients’ neurological function is not only of utmost relevance for individual patients’ quality of life, but may also decrease the economic burden due to work loss frequently encountered in glioma patients.
