Preoperative predictive factors affecting return to work in patients with gliomas undergoing awake brain mapping

J Neurooncol. 2020 Jan;146(1):195-205. doi: 10.1007/s11060-019-03371-0. Epub 2019 Dec 18.

Abstract

Purpose: This study aimed to investigate the preoperative predictive factors affecting return to work in patients with gliomas in the left cerebral hemisphere undergoing awake surgery.

Methods: We retrospectively reviewed 50 consecutive glioma patients who underwent awake surgery from January 2012 to July 2017. Adult patients older than 18 years, who reported working prior to surgery, were recruited for this study.

Results: Comparing sociodemographic, disease-related and preoperative neurocognitive variables of glioma patients who returned to work and those who did not, binomial logistic regression models for preoperative predictors affecting return to work revealed significant differences in age and sole breadwinner status as sociodemographic variables, tumour volume as a disease-related variable, and Verbal IQ, Performance IQ, general memory, attention/concentration, and working memory as neurocognitive variables. Multivariate logistic regression models demonstrated that the independent factors associated with propriety of returning to work 1 year after surgery was the sociodemographic variable sole breadwinner status (yes vs no; OR = 15.00, 95% CI 2.22-101.35, p = 0.01), the disease-related variable tumour volume (per 1 cm3; OR = 0.98, 95% CI 0.96-0.99, p = 0.04), and the preoperative neurocognitive variable general memory (≥ 100 vs < 100; OR = 21.70, 95% CI 2.60-183.94, p = 0.01).

Conclusions: Our results suggest that three predictive factors including sole breadwinner status, tumour volume and general memory that can be assessed in the preoperative stage substantially contribute to returning to work in patients with gliomas in the left cerebral hemisphere, 1 year after awake surgery.

Keywords: Awake brain mapping; Brain tumour; Cognitive function; Preoperative predictive factor; Return to work; Sole breadwinner.

MeSH terms

  • Adult
  • Aged
  • Brain Mapping / methods*
  • Brain Neoplasms / pathology
  • Brain Neoplasms / psychology
  • Brain Neoplasms / surgery*
  • Cognition
  • Craniotomy / methods*
  • Female
  • Follow-Up Studies
  • Glioma / pathology
  • Glioma / psychology
  • Glioma / surgery*
  • Humans
  • Income
  • Male
  • Memory
  • Middle Aged
  • Monitoring, Intraoperative
  • Predictive Value of Tests
  • Preoperative Care*
  • Prognosis
  • Quality Indicators, Health Care*
  • Retrospective Studies
  • Return to Work / statistics & numerical data*
  • Social Change
  • Tumor Burden
  • Wakefulness
  • Young Adult