Risk factors, predictive models, and general work ability trajectory in patients with glioma

Glioma research has increasingly emphasized quality of life alongside traditional survival metrics, emphasizing functional outcomes, symptom burden, and social reintegration, including the ability to work. While previous studies focused on return-to-work rates, we assessed general work ability as a broader measure of work capacity. We aimed to develop predictive models for general work ability recovery, identify key risk factors, and explore long-term trajectories.

We conducted a retrospective cohort study of 342 patients with glioma (aged 18-64, WHO Grades 2-4) between March 2010 and December 2018. Work ability and symptoms were assessed using the M.D. Anderson Symptom Inventory-Brain Tumor Module (MDASI-BT), which was administered at months 1 and 3 postoperatively, then every three months up to 12 months, and at longer intervals thereafter. Logistic regression predicted 6-month general work ability recovery, and Cox models identified long-term risk factors. Long-term monitoring was conducted to evaluate the stability of work ability recovery across different WHO grades.

65.2% (223/342) regaining general work ability within 6 months post-surgery. Brain tumor-specific symptoms were stronger predictors of recovery than general symptoms. Predictive models achieved AUCs of 0.78 (pre-surgery) and 0.82 (post-surgery). Long-term monitoring showed recovery instability, with cumulative recovery rates for WHO Grades 2-4 at 82.1%, 50.8%, and 28.2%, respectively, while peaks at 50.8%, 28.3%, and 7.3%.

Brain tumor-specific symptoms significantly impact general work ability recovery. Recovery instability was observed across all patients, underscoring the importance of targeted symptom management, personalized care, and sustained follow-up to improve quality of life.