Return to work following diagnosis of low-grade glioma: A nationwide matched cohort study

Objective: Return-to-work (RTW) following diagnosis of infiltrative
low-grade gliomas (LGG) is unknown.   Methods: Swedish patients
with histopathological verified WHO grade II diffuse glioma diagnosed
between 2005-2015 were included. Data were acquired from several Swedish
registries. A total of 381 patients aged 18-60 were eligible. A matched
control population (n=1900) was acquired. Individual data on sick leave,
compensations, comorbidity, and treatments assigned were assessed.
Predictors were explored using multivariable logistic
regression.  Results: One year before surgery/index date, 88 % of
cases were working compared to 91 % of controls. The proportion of
controls working remained constant, while patients had a rapid increase in
sick leave approximately six months prior to surgery. After one and two
years respectively, 52 % and 63 % of the patients were working. Predictors
for no-RTW after one year were previous sick leave (OR 0.92, 95 % CI
0.88-0.96, p <0.001), older age (OR 0.96, 95 % CI 0.94-0.99,
p=0.005) and lower functional level (OR 0.64 95% CI, 0.45-0.91 p=0.01).
Patients receiving adjuvant treatment were less likely to RTW within the
first year. At two years, biopsy (as opposed to resection), female sex and
co-morbidity were also unfavorable, while age and adjuvant treatment were
no longer significant.  Conclusions: Approximately half of the
patients RTW within the first year. Lower functional status, previous sick
leave, older age, and adjuvant treatment were risk factors for no-RTW at
one year after surgery. Female sex, co-morbidity, and biopsy only were
also unfavorable for RTW at two years.