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Returning to work after multimodal treatment in glioblastoma patients.

Posted on: 06/02/2018

Neurosurg Focus. 2018 Jun;44(6):E17. doi: 10.3171/2018.3.FOCUS1819.

Returning to work after multimodal treatment in glioblastoma patients.

Starnoni D1, Berthiller J2, Idriceanu TM1, Meyronet D3,4, d'Hombres A5, Ducray F6,7, Guyotat J1.
Author information:
1. Neurosurgical Department, Oncological and Vascular Service, Pierre Wertheimer University Hospital, Lyon.
2. Clinical Investigation Centre CIC-INSERM 1407, EPICIME, Department of Clinical Pharmacology, Hospices Civils de Lyon.
3. Université Claude Bernard Lyon 1, Lyon.
4. Hospices Civils de Lyon, Groupe Hospitalier Est, Service de Neuropathologie, Lyon; and.
5. Département de Radiothérapie, Centre Hospitalier Universitaire Lyon Sud, Pierre-Bénite, France.
6. Hospices Civils de Lyon, Groupe Hospitalier Est, Service de Neuro-Oncologie, Lyon.
7. Department of Cancer Cell Plasticity, Cancer Research Centre of Lyon, INSERM U1052, CNRS UMR5286, Lyon.
OBJECTIVE Although multimodal treatment for glioblastoma (GBM) has resulted in longer survival, uncertainties exist regarding health-related quality of life and functional performance. Employment represents a useful functional end point and an indicator of social reintegration. The authors evaluated the rate of patients resuming their employment and the factors related to work capacity.
METHODS The authors performed a retrospective study of working-age patients treated with surgery and radiochemotherapy between 2012 and 2015. Data were collected before and after surgery and at 6, 12, 18, and 24 months. Employment was categorized according to the French Socio-Professional Groups and analyzed regarding demographic and clinical data, performance status, socio-professional category, radiological features, type, and quality of resection.
RESULTS A total of 125 patients, mean age 48.2 years, were identified. The mean follow-up was 20.7 months with a median survival of 22.9 months. Overall, 21 patients (18.3%) went back to work, most on a part-time basis (61.9%). Of the patients who were alive at 6, 12, 18, and 24 months after diagnosis, 8.7%, 13.8%, 15.3%, and 28.2%, respectively, were working. Patients going back to work were younger (p = 0.03), had fewer comorbidities (p = 0.02), and had a different distribution of socio-professional groups, with more patients belonging to higher occupation categories (p = 0.02). Treatment-related symptoms (36.2%) represented one of the main factors that prevented the resumption of work. Employment was strongly associated with performance status (p = 0.002) as well as gross-total removal (p = 0.04). No statistically significant difference was found regarding radiological or molecular features and the occurrence of complications after surgery.
CONCLUSIONS GBM diagnosis and treatment has a significant socio-professional impact with only a minority of patients resuming work, mostly on a part-time basis.


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