Initial Experience Using Awake Surgery for Glioma

Mandonnet, Emmanuel; Hamer, Philip C. De Witt; Poisson, Isabelle; Whittle, Ian R.; Bernat, Anne-Laure; Bresson, D.; Madadaki, C.; Bouazza, S.; Ursu, Rénata; Carpentier, Antoine F.; George, Bernard; Froelich, Sébastien

doi:10.1227/neu.0000000000000644

Cited by 81 publications

(19 citation statements)

References 29 publications

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“…This result is similar to those of other studies in which the percentage varies from 43 to 86% although it is calculated after a longer period from surgery (Kalkanis et al, 2000;Akagami et al, 2002;Krupp et al, 2009;Schepers et al, 2018;Thurin et al, 2019). In the glioma group, 31% of patients returned to work, and this percentage is lower than in studies on low-grade glioma or mixed diagnosis (Mandonnet et al, 2015;Muto et al, 2018;Ng et al, 2019;Senft et al, 2020;Yoshida et al, 2020) but very similar to other studies on patients with glioblastoma (Gzell et al, 2014;Starnoni et al, 2018), and this result could be explained by the higher rate of high-grade glioma in our sample (75.9%). Among people returning to work, most patients with glioma and fewer than half of patients with meningioma changed their working tasks and reduced working time.…”

Section: Discussionsupporting

confidence: 88%

Characteristics of Patients Returning to Work After Brain Tumor Surgery

Schiavolin

Mariniello

Broggi

et al. 2021

Front. Hum. Neurosci.

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Objective: To investigate the differences between patients returning to work and those who did not after brain tumor surgery.Methods: Patients were evaluated before surgery and after 3 months. The Montreal Cognitive Assessment test, Trail-Making Test (parts A and B), 15-word Rey–Osterrieth Word List (immediate and delayed recall), F-A-S tests, and Karnosfky Performance Status were used to assess cognitive status, attention, executive functions, memory, word fluency, and functional status. Patient-reported outcome measures (PROMs) used to evaluate emotional distress and disability were the Hospital Anxiety and Depression Scale and World Health Organization Disability Assessment Schedule. Clinical and work-related variables, PROMs, and cognitive tests were compared using chi-squared, t-test or Mann–Whitney U test.Results: Sixty patients were included. Patients returning to work were 61.3 and 31.0% among people with meningioma and glioma, respectively. They reported lower postoperative disability and lesser home-to-work travel time. Patients with meningioma also showed better preoperative and postoperative attention and executive functions, better postoperative functional and cognitive status, and lower frequency of treatments.Conclusions: These variables should be considered in a clinical context to plan interventions for people who need support during return to work and in future research to investigate preoperative and postoperative predictive factors of going back to work.

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Section: Discussionsupporting

confidence: 88%

Characteristics of Patients Returning to Work After Brain Tumor Surgery

Schiavolin

Mariniello

Broggi

et al. 2021

Front. Hum. Neurosci.

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“…Instead, studies tend to vary regarding characteristics and prognosis and focus more on specific surgical techniques. 16 , 17 , 27 Comparison with these studies is of limited value since potential factors possibly affecting RTW, as we also demonstrate, will go unnoticed in smaller studies of highly selected patients. In a study on long-term progression-free survivors with anaplastic oligodendrogliomas and oligoastrocytomas, RTW after 2.5 years following diagnosis was 41%.…”

Section: Discussionmentioning

confidence: 88%

Return to work following diagnosis of low-grade glioma

et al. 2020

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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 comorbidity 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, comorbidity and biopsy only were also unfavorable for RTW at two years.

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“…We frequently use awake surgery for tumor resection, and in our current series, more than half of the patients underwent awake craniotomy. Other groups have argued that awake surgery may facilitate return to work [33][34][35], most likely because of the high chance of preserving neurological function. While in general glioma surgery may result in a survival benefit [36,37] or relief from tumor symptoms [38], our results did not show an effect of extent of resection on the ability or duration of patients returning to work.…”

Section: Discussionmentioning

confidence: 99%

The ability to return to work: a patient-centered outcome parameter following glioma surgery

et al. 2020

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Background With refinements in diagnosis and therapy of gliomas, the importance of survival time as the sole outcome parameter has decreased, and patient-centered outcome parameters have gained interest. Pursuing a profession is an indispensable component of human happiness. The aim of this study was to analyze the professional outcomes besides their neuro-oncological and functional evaluation after surgery for gliomas in eloquent areas. Methods We assessed neuro-oncological and functional outcomes of patients with gliomas WHO grades II and III undergoing surgery between 2012 and 2018. All patients underwent routine follow-up and adjuvant treatment. Treatment and survival parameters were collected prospectively. Repercussions of the disease on the patients’ professional status, socio-economic situation, and neurocognitive function were evaluated retrospectively with questionnaires. Results We analyzed data of 58 patients with gliomas (WHO II: 9; III: 49). Median patient age was 35.8 years (range 21–63 years). Awake surgery techniques were applied in 32 patients (55.2%). Gross total and subtotal tumor resections were achieved in 33 (56.9%) and 17 (29.3%) patients, respectively, whereas in 8 patients (13.8%) resection had to remain partial. Most patients (n = 46; 79.3%) received adjuvant treatment. Median follow up was 43.8 months (range 11–82 months). After treatment 41 patients (70.7%) were able to resume a working life. Median time until returning to work was 8.0 months (range 0.2–22.0 months). To be younger than 40 at the time of the surgery was associated with a higher probability to return to work (p < .001). Multivariable regression analysis showed that patient age < 40 years as well as occupational group and self-reported fatigue were factors independently associated with the ability to return to work. Conclusion The ability to resume professional activities following brain tumor surgery is an important patient-oriented outcome parameter. We found that the majority of patients with gliomas were able to return to work following surgical and adjuvant treatment. Preservation of neurological function is of utmost relevance for individual patients´ quality of life.

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Initial Experience Using Awake Surgery for Glioma

Abstract: These oncological and functional results of awake glioma surgery during the learning curve are comparable to results from established centers. The use and utility of resection probability maps are well demonstrated. The return to work level is high.

Cited by 81 publications

References 29 publications

Characteristics of Patients Returning to Work After Brain Tumor Surgery

Characteristics of Patients Returning to Work After Brain Tumor Surgery

Return to work following diagnosis of low-grade glioma

The ability to return to work: a patient-centered outcome parameter following glioma surgery

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