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.