The need to consider return to work as a main outcome in patients undergoing surgery for diffuse low-grade glioma: a systematic review
- 9 August 2022
- journal article
- review article
- Published by Springer Science and Business Media LLC in Acta Neurochirurgica
- Vol. 164 (10), 2789-2809
- https://doi.org/10.1007/s00701-022-05339-y
Abstract
Objective For a long time, return to work (RTW) has been neglected in patients harboring a diffuse low-grade glioma (LGG). However, a majority of LGG patients worked at time of diagnosis. Moreover, these patients now live longer given current treatment paradigms, especially thanks to early maximal surgery. Methods We systematically searched available medical databases for studies that reported data on RTW in patients who underwent resection for LGG. Results A total of 30 studies were selected: 19 considered RTW (especially rate and timing) as an outcome and 11 used scales of health-related quality of life (HRQoL) which included work-related aspects. Series that considered RTW as a main endpoint were composed of 1014 patients, with postoperative RTW rates ranging from 31 to 97.1% (mean 73.1%). Timing to RTW ranged from 15 days to 22 months (mean 6.3 months). Factors related to an increased proportion of RTW were: younger age, better neurologic status, having a white-collar occupation, working pre-operatively, being the sole breadwinner, the use of awake surgery, and greater extent of resection. Female sex, older age, poor neurologic status, pre-operative history of work absences, slow lexical access speed, and postoperative seizures were negatively related to RTW. No studies that used HRQoL scales directly investigated RTW rate or timing. Conclusions RTW was scarcely analyzed in LGG patients who underwent resection. However, because they are usually young, with no or only mild functional deficits and have a longer life expectancy, postoperative RTW should be assessed more systematically and accurately as a main outcome. As majority (61.5–100%) of LGG patients were working at time of surgery, the responsibility of neurosurgeons is to bring these patients back to their previous activities according to his/her wishes. RTW might also be included as a critical endpoint for future prospective studies and randomized control trials on LGGs.Keywords
This publication has 105 references indexed in Scilit:
- Spontaneous and therapeutic prognostic factors in adult hemispheric World Health Organization Grade II gliomas: a series of 1097 casesJournal of Neurosurgery, 2013
- Intractable epilepsy in paralimbic World Health Organization Grade II gliomas: should the hippocampus be resected when not invaded by the tumor?Journal of Neurosurgery, 2012
- Awake surgery for WHO Grade II gliomas within “noneloquent” areas in the left dominant hemisphere: toward a “supratotal” resectionJournal of Neurosurgery, 2011
- Health-related quality of life in glioma patients in ChinaBMC Cancer, 2010
- Awake Mapping Optimizes the Extent of Resection for Low-Grade Gliomas in Eloquent AreasNeurosurgery, 2010
- BYPASS SURGERY FOR COMPLEX BRAIN ANEURYSMSNeurosurgery, 2009
- Functional outcome after language mapping for insular World Health Organization Grade II gliomas in the dominant hemisphere: experience with 24 patientsNeurosurgical Focus, 2009
- Quality of life in low-grade glioma patients receiving temozolomideNeuro-Oncology, 2009
- Work Productivity in Brain Tumor SurvivorsJournal of Occupational and Environmental Medicine, 2007
- Surgical removal of corpus callosum infiltrated by low-grade glioma: functional outcome and oncological considerationsJournal of Neurosurgery, 2004