Yuan Xin'er, Zhang Jie, Wu Shuai, Luo Chen, Yao Ye
Department of Biostatistics, School of Public Health & National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China.
Neurosurgical Institute of Fudan University, Shanghai, China.
Neurooncol Adv. 2025 May 7;7(1):vdaf094. doi: 10.1093/noajnl/vdaf094. eCollection 2025 Jan-Dec.
Glioma research has increasingly emphasized quality of life alongside traditional survival metrics, emphasizing functional outcomes, symptom burden, and social reintegration, including the ability to work. While previous studies focused on return-to-work rates, we assessed general work ability as a broader measure of work capacity. We aimed to develop predictive models for general work ability recovery, identify key risk factors, and explore long-term trajectories.
We conducted a retrospective cohort study of 342 patients with glioma (aged 18-64, WHO Grades 2-4) between March 2010 and December 2018. Work ability and symptoms were assessed using the M.D. Anderson Symptom Inventory-Brain Tumor Module (MDASI-BT), which was administered at months 1 and 3 postoperatively, then every three months up to 12 months, and at longer intervals thereafter. Logistic regression predicted 6-month general work ability recovery, and Cox models identified long-term risk factors. Long-term monitoring was conducted to evaluate the stability of work ability recovery across different WHO grades.
65.2% (223/342) regaining general work ability within 6 months post-surgery. Brain tumor-specific symptoms were stronger predictors of recovery than general symptoms. Predictive models achieved AUCs of 0.78 (pre-surgery) and 0.82 (post-surgery). Long-term monitoring showed recovery instability, with cumulative recovery rates for WHO Grades 2-4 at 82.1%, 50.8%, and 28.2%, respectively, while peaks at 50.8%, 28.3%, and 7.3%.
Brain tumor-specific symptoms significantly impact general work ability recovery. Recovery instability was observed across all patients, underscoring the importance of targeted symptom management, personalized care, and sustained follow-up to improve quality of life.
胶质瘤研究在传统生存指标之外，越来越强调生活质量，重视功能结果、症状负担和社会重新融入，包括工作能力。虽然先前的研究聚焦于重返工作岗位的比率，但我们将一般工作能力作为工作能力的更广泛衡量指标进行评估。我们旨在开发一般工作能力恢复的预测模型，识别关键风险因素，并探索长期轨迹。
我们对2010年3月至2018年12月期间的342例胶质瘤患者（年龄18 - 64岁，世界卫生组织2 - 4级）进行了一项回顾性队列研究。使用MD安德森症状问卷-脑肿瘤模块（MDASI - BT）评估工作能力和症状，该问卷在术后1个月和3个月进行施测，然后每三个月进行一次，直至12个月，此后间隔更长时间进行。逻辑回归预测6个月的一般工作能力恢复情况，Cox模型识别长期风险因素。进行长期监测以评估不同世界卫生组织分级中工作能力恢复情况的稳定性。
65.2%（223/342）的患者在术后6个月内恢复了一般工作能力。脑肿瘤特异性症状比一般症状更能预测恢复情况。预测模型的曲线下面积在术前为0.78，术后为0.82。长期监测显示恢复情况不稳定，世界卫生组织2 - 4级的累积恢复率分别为82.1%、50.8%和28.2%，而峰值分别为50.8%、28.3%和7.3%。
脑肿瘤特异性症状显著影响一般工作能力恢复。在所有患者中均观察到恢复不稳定情况，这突出了针对性症状管理、个性化护理以及持续随访以改善生活质量的重要性。
