# Factors associated with period of sick leave after gynecologic cancer treatment: a prospective cohort study

## TL;DR

This study finds that gynecologic cancer survivors who underwent surgery plus extensive chemotherapy had the longest sick leave periods after treatment.

## Contribution

Identifies treatment type and adverse effects as key factors influencing sick leave duration after gynecologic cancer treatment.

## Key findings

- Surgery plus more than six chemotherapy courses was associated with significantly longer sick leave.
- Adverse effects after treatment were strongly linked to extended sick leave periods.
- Patients with longer treatment durations required more time to return to work.

## Abstract

Gynecologic cancer is one of the most common malignancies in working-age women. This study aimed to investigate factors associated with period of sick leave after gynecologic cancer treatment in Japan.

A prospective cohort study on period of sick leave was conducted among 207 cancer survivors who returned to work at the same workplace. Questionnaires were randomly distributed to patients aged under 65 years and more than one-year post-treatment. Clinical information was extracted from medical records, and the factors influencing the period of sick leave were analyzed using the Mann–Whitney U test and logistic regression analysis.

Surgery plus more than six courses of chemotherapy (number (n) = 41, 166.02 ± 146.84 days) led to a significantly longer period of sick leave than surgery without lymph node dissection (n = 64, 31.15 ± 30.47 days), surgery with lymph node dissection (n = 41, 55.56 ± 85.90 days), surgery plus less than six courses of chemotherapy (n = 21, 72.42 ± 56.07 days), and radiotherapy alone (n = 21, 58.85 ± 84.24 days) (OR: 2.63, 2.95, 2.67, and 2.08; 95% CI: 7.71–54.59, 18.17–92.94, 18.22–126.63, and 2.38–115.33; p = 0.009, p = 0.004, p = 0.009, and p = 0.041). gynecologic cancer survivors who experienced adverse effects after treatment had a significantly longer period of sick leave (OR: 8.50; CI: 52.98–84.98; p < 0.001). In univariate and multivariate analyses, patients who received surgery plus more than six courses of chemotherapy were most involved in long period of sick leave than other factors (OR: 11.20, and 16.997; CI: 4.86–25.08, and 5.51–52.35; p < 0.001, and p < 0.001).

Patients with gynecologic cancer requiring long-term treatment required the most time to return to work.

The online version contains supplementary material available at 10.1007/s00520-025-10116-5.