gms | German Medical Science

Objective: Maximum safe tumor resection is the first step in the multimodal treatment of gliomas. Aside from improving overall survival, patient centered outcome parameters are gaining importance. Among others, the occupational status represents one such parameter. Our aim was to report the proportion of patients who are able to return to work (RTW) following glioma surgery and to identify factors influencing occupational status.

Methods: We retrospectively analyzed our prospectively collected database of glioma patients operated upon between 2013 and 2018. All patients received treatment according to interdisciplinary tumor board recommendation. Patients with WHO grade IV tumors were excluded from the analysis. Clinical data were retrieved from the database. Details on occupational status before and after surgery were obtained by structured telephone interviews.All patients gave informed consent to participate in this study.

Results: 69 patients were included in the analysis. Median age was 38 years (range: 21-70). The majority of patients (n=56) had WHO grade III tumors, followed by grade II (n=10) and grade I tumors (n=3). Most patients received adjuvant treatment (n=59). Median follow-up time was 38.7 months (range: 5.4-77.8 months). At diagnosis, 59 patients (85.6%) were working. Later, 40 patients (67.8%) were able to RTW. The median time to RTW was 8.0 months. Multivariable analysis showed that age at diagnosis, employment status at diagnosis, KPS at diagnosis and at follow up as well as extent of tumor resection were associated with the ability to RTW (p<0.001, p<0.01, p<0.05, p<0.001, and p<0.05, respectively). While the proportion of patients able to RTW was higher after awake than after non-awake surgery (63.2 vs. 51.6%), this difference was not statistically significant (p=0.46). Likewise, tumor histology or WHO grade were not statistically significantly associated with the ability to RTW (p>0.05 for both).

Conclusion: Social interaction and self-sustainment affect personal well-being. Following tumor surgery, a large proportion of patients is able to RTW, even when tumors are eloquently located. Maximizing the extent of resection while preserving function is of paramount importance for maintaining patients’ quality of life.