Return to work and factors influencing recovery after endoscopic transsphenoidal surgery for hypothalamic and pituitary tumors

This study investigated the return-to-work (RTW) rates and associated factors following endoscopic transsphenoidal surgery (eTSS) among patients with pituitary and hypothalamic tumors in Japan. The primary research question aimed to determine the variables affecting early RTW post-surgery. A retrospective analysis was conducted on 44 preoperatively employed patients who underwent eTSS at a single center between April 2018 and January 2025. Clinical data, including demographics, tumor characteristics, comorbidities, and perioperative variables, were extracted from the medical records. The primary outcome was RTW within 3 months of surgery. Statistical analyses were performed using t-tests and Fisher's exact tests. The median time to RTW was 5 weeks, and the RTW rates were 38.6%, 69.5%, and 75.0% at 1, 3, and 6 months, respectively, with an overall RTW rate of 84.1%. Factors such as a prolonged length of hospital stay (LOS), mental disorders, and the absence of prior TSS were significantly linked to delayed RTW at 3 months. Mental disorders also tended to decrease RTW at 6 months. No significant associations were found between adequate hormone replacement and age, sex, tumor type, or endocrinological dysfunction. Patients receiving multidisciplinary support for RTW tended to experience longer recovery periods, possibly reflecting a greater need. In patients undergoing eTSS for pituitary region tumors, a history of mental disorders, prolonged LOS, and no history of prior TSS were key factors could be associated with delayed RTW. Early identification of these factors may facilitate tailored multidisciplinary RTW support strategies.