Resection Location and Work Resumption in Patients With Lower-Grade Glioma: A Multicenter Cohort Study

BACKGROUND AND OBJECTIVES: Patients with newly diagnosed lower-grade glioma (World Health Organization grade II and III) are typically of working age. However, work resumption after surgical resection is uncertain, possibly due to loss of capacity from resection of tumor-infiltrated brain regions. Therefore, we explore the association between work resumption and the resection location in addition to other patient, tumor, and treatment characteristics. METHODS: This retrospective cohort consisted of adults undergoing first-time resection for lower-grade glioma between 2011 and 2020 in hospitals in France, Germany, and the Netherlands. Employment was evaluated at baseline and within 1 year after surgery to determine work resumption. The association between work resumption and patient, tumor, and treatment characteristics was analyzed using logistic regression. Resection cavities were segmented from postoperative MRI scans, registered to standard brain space and related to gray nuclei, cortical networks, and white matter tracts using atlas parcellations. To identify brain regions potentially involved with work resumption, the association between work resumption and resection location was analyzed using Bayesian hurdle regression. The identified regions and characteristics were jointly analyzed in their association with work resumption using multiple logistic regression. RESULTS: Of 207 patients, 181 (87%) were employed at baseline. Of these employed patients, 111 (61%) had resumed work at follow-up. Male sex, younger age, and larger extent of resection were independent significant predictors of work resumption. Resection location was not associated with work resumption. CONCLUSION: Almost two-thirds of patients resumed work 1 year after surgery. Work resumption was associated with patient characteristics (male sex and younger age) and extent of resection, but not with resection location.