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Long-term employment status in patients with World Health Organization grade II gliomas and the association with fatigue

Ellen M. P. van Coevorden-van Loon, Willemijn Ernens, Majanka H. Heijenbrok-Kal, Herwin L. D. Horemans, Gerard M. Ribbers, Martin J. van den Bent
Department of Neurorehabilitation Medicine, Rijndam Rehabilitation, Rotterdam, The Netherlands. E-mail:
DOI: 10.2340/16501977-2837

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Objective: To investigate employment status and return to work in relation to fatigue in patients with World Health Organization (WHO) grade II glioma.
Design: Exploratory cross-sectional study.
Subjects: Patients with grade II glioma, who underwent surgery between 2005 and 2016.
Methods: A postal survey was sent in 2019, which included the Short Form-Health and Labour Questionnaire and the Multi-dimensional Fatigue Index. Outcomes of fatigue in subgroups of (not-)return to work were compared using independent
t-tests and χ2 tests. The association between fatigue and return to work was analysed using multivariable logistic regression.
Results: In total, 73 patients were included in the study (age at diagnosis 41.0 years (standard deviation (SD) 9.2 years), time post-diagnosis 8.0 years (interquartile range (IQR) 6–11 years). At diagnosis, 61 patients were employed and 32 returned to work during follow-up. The return to work group was significantly younger than the not-return to work group (p = 0.007). The proportion of patients who indicated that the consequences of glioma had affected return to work, in terms of demotion or reduced working hours, was 68.7%. The not-return to work group reported significantly more fatigue in all domains than the return to work group (p < 0.05). Mental fatigue (p = 0.023) and physical fatigue (p = 0.065) were independently associated with return to work, adjusted for age, sex and the use of anti-epileptic drugs.
Conclusion: Long-term fatigue is associated with return to work in patients with grade II glioma.

Lay Abstract

Patients with glioma have adult brain cancer. These patients are relatively young when they develop this disease. Treatment options for glioma have improved over recent years, and patients will survive approximately 5–15 years. Almost all patients are of working age. Because of the increased survival time, patients find it important to continue to participate in society, especially in work. This study examined working patterns in patients with glioma several years after the start of their disease. Fifty-two percent of patients were working 8 years after the diagnosis of glioma. Many patients with brain tumours felt tired (fatigued), both mentally and physically. Patients who were able to work in the long term were less fatigued, younger, more often male, and used less anti-epileptic drugs than the patients who did not return to work.


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