Department of Rehabilitation Science, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Rehabilitation, Nagoya University Hospital, Nagoya, Japan.
J Neurooncol. 2020 Jan;146(1):195-205. doi: 10.1007/s11060-019-03371-0. Epub 2019 Dec 18.
This study aimed to investigate the preoperative predictive factors affecting return to work in patients with gliomas in the left cerebral hemisphere undergoing awake surgery.
We retrospectively reviewed 50 consecutive glioma patients who underwent awake surgery from January 2012 to July 2017. Adult patients older than 18 years, who reported working prior to surgery, were recruited for this study.
Comparing sociodemographic, disease-related and preoperative neurocognitive variables of glioma patients who returned to work and those who did not, binomial logistic regression models for preoperative predictors affecting return to work revealed significant differences in age and sole breadwinner status as sociodemographic variables, tumour volume as a disease-related variable, and Verbal IQ, Performance IQ, general memory, attention/concentration, and working memory as neurocognitive variables. Multivariate logistic regression models demonstrated that the independent factors associated with propriety of returning to work 1 year after surgery was the sociodemographic variable sole breadwinner status (yes vs no; OR = 15.00, 95% CI 2.22-101.35, p = 0.01), the disease-related variable tumour volume (per 1 cm; OR = 0.98, 95% CI 0.96-0.99, p = 0.04), and the preoperative neurocognitive variable general memory (≥ 100 vs < 100; OR = 21.70, 95% CI 2.60-183.94, p = 0.01).
Our results suggest that three predictive factors including sole breadwinner status, tumour volume and general memory that can be assessed in the preoperative stage substantially contribute to returning to work in patients with gliomas in the left cerebral hemisphere, 1 year after awake surgery.
本研究旨在探讨左脑半球胶质瘤患者行清醒开颅手术时影响术后重返工作的术前预测因素。
我们回顾性分析了 2012 年 1 月至 2017 年 7 月期间 50 例连续接受清醒手术的胶质瘤患者。本研究招募了术前报告工作的成年患者。
对术后重返工作和未重返工作的胶质瘤患者的社会人口统计学、疾病相关和术前神经认知变量进行比较,二项逻辑回归模型对术前预测因素进行分析,结果显示影响术后重返工作的社会人口统计学变量有年龄和唯一养家糊口者身份,疾病相关变量有肿瘤体积,神经认知变量有言语智商、操作智商、一般记忆、注意力/集中力和工作记忆。多变量逻辑回归模型显示,与术后 1 年是否适合重返工作相关的独立因素是社会人口统计学变量唯一养家糊口者身份(是 vs 否;OR=15.00,95%CI 2.22-101.35,p=0.01)、疾病相关变量肿瘤体积(每 1cm;OR=0.98,95%CI 0.96-0.99,p=0.04)和术前神经认知变量一般记忆(≥100 分 vs <100 分;OR=21.70,95%CI 2.60-183.94,p=0.01)。
我们的结果表明,术前可评估的三个预测因素,包括唯一养家糊口者身份、肿瘤体积和一般记忆,对左脑半球胶质瘤患者术后 1 年重返工作有显著贡献。