Predictors of return to work following surgery in patients with glioblastoma: a retrospective multicenter study

While clinical outcomes of glioblastoma (GBM) are well-documented, its socio-economic impact, particularly on return to work (RTW) remains unexplored. In this study we aimed to identify the predictors of RTW at 6 months postoperatively in patients undergoing GBM treatment and to assess its association with post-operative neurological deficits and median overall survival (mOS).

We retrospectively studied 106 adults with pre-operative employment, undergoing primary GBM resection or biopsy at three tertiary centers. RTW at 3 and 6 months postoperatively were assessed using univariate and multivariate analyses.

After 6 months 33 patients (33.1%) were able to RTW. Factors associated with lower odds of RTW included female sex (p = 0.039), Karnofsky Performance Scale (KPS) < 80 at 2 weeks (p = 0.034), and 3 months post-operatively (p = 0.0001), right handedness (p = 0.038), and subtotal resection (p = 0.042). On multivariate analysis female sex (OR 0.238, 95% CI 0.077-0.733, p = 0.012) and three-month postoperative KPS < 80 (OR 0.019, 95% CI 0.001-0.0293, p = 0.004) were the least likely to RTW at six months. Acute postoperative motor (p = 0.047), gait (p = 0.008) and cognitive deficits (p = 0.048) and persistent motor (p = 0.017), gait (p = 0.033) and language (p = 0.026) deficits were all associated with lesser RTW. Patients who returned to work had significantly longer mOS (21.44, p < 0.001).

RTW at 6 months post GBM Surgery corelates with improved mOS. Female sex and lower post-operative KPS scores were the strongest predictors of reduced RTW.