Evaluating work activity and societal burden in patients with grade 2 IDH-mutant glioma

BACKGROUND: IDH-mutant (mIDH) gliomas affect relatively young and otherwise healthy patients with high workforce participation. Management typically involves surgery, radiotherapy, and/or chemotherapy (RT/CT), although immediate post-surgery treatment may be deferred in favor of active observation (AO) to preserve functioning. This study aimed to evaluate how disease progression and treatments impact work activity, medical and societal costs, and overall survival (OS) in grade 2 mIDH glioma patients initially managed with AO.

METHODS: This retrospective longitudinal study utilized Danish administrative registries. Patients with mIDH gliomas initially managed with AO between 2010 and 2022 were included. Employment rates, sick leaves, treatment patterns, medical resources and costs, and OS were examined from diagnosis to the end of follow-up or death.

RESULTS: Data from 237 patients were analyzed; 72.9% were alive at 10 years. After surgical recovery, ability to work was most impaired during RT/CT, necessitating nearly full-time sick leave. Work activity continuously decreased after each RT/CT treatment. Employment rates were similarly affected, from under 20% unemployment at baseline and during AO, up to 41% and 59% after first and second RT/CT. Similar trends were observed for medical resources and costs, and productivity losses.

CONCLUSIONS: Patients with grade 2 mIDH glioma remain active at work after initial surgery when managed with AO. Work impairment increases over successive RT/CT courses, highlighting the need to preserve quality of life by integrating work ability into clinical practice and by developing new treatment strategies to delay aggressive therapies and avoid substantial medical and productivity costs.