Cognitive and Clinical Factors Predicting Return to Work After IDH-mutant Glioma Surgery: Why Clinicians Should Closely Examine Verbal Fluency Scores

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ID: 322475
2026
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Abstract
Abstract Background Returning to work after IDH-mutant glioma surgery can be hindered by cognitive impairment. In this study, we analyzed the predictive value of verbal fluency on return to work (RTW). Methods We retrospectively analyzed 72 surgeries (including 6 reoperations) performed between 2012 and 2025 for diffuse IDH-mutant glioma grade 2 and 3 in 66 patients (mean age 38.5± 8.5). All patients were employed at surgery and assessed for RTW status one year postoperatively. Multiple semantic fluency (SF) and phonemic fluency (PF) metrics were first compared against 274 matched controls. Clinical and professional variables, along with pre-to-postoperative changes in verbal SF and PF scores, were then analyzed for their predictive value on RTW. Results RTW rate was 77.8% (mean delay 5.2 months ± 2.9). In both PF and SF, patients produced significantly fewer words (p < .001) and more repetitions (p < .05) than controls. Multivariate analysis identified four independent predictors of non-RTW: grade 3 glioma (OR = 0.07; 95% CI [0.01–0.47]; p = .006), precarious employment contract vs salaried or self-employed workers (OR≈40, p < .05), decrease in PF total Z-score (OR = 4.28; CI 95% [1.30 – 14.05]; p = .017), and decrease in SF total Z-score (OR = 4.15; CI 95% [1.31 – 13.13]; p = .015). Conclusions Four months post-surgery, one standard deviation decline in both total PF and SF scores is a predictor of non-return to work. For these patients, reinforced cognitive rehabilitation and personalized workplace accommodations are warranted to facilitate work resumption.
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Authors Marion Barberis, Logan Gaudet, Adrià Rofes, Isabelle Poisson, Sophie Letrange, Cécile Tarabon, Cécile Deniset, Mikaël Mazighi, Sébastien Froelich, Guillaume Herbet, Emmanuel Mandonnet
Journal Neuro-Oncology Practice
Year 2026
DOI
10.1093/nop/npag070
URL
https://doi.org/10.1093/nop/npag070
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