Understanding glioblastoma survival: A SEER-based study of demographics and treatment.

Abstract

e14027 Background: Glioblastoma is an aggressive brain tumor characterized by rapid progression, high recurrence, and poor survival. Prognosis is influenced by genetic factors, environmental exposures, and demographics such as age and gender, highlighting the importance of identifying prognostic factors. Methods: Glioblastoma cases from the Surveillance, Epidemiology, and End Results (SEER) database (2000–2021) were identified using ICD-O-3 histology code 9440/3. Demographic variables included sex, race, residence, and year of diagnosis, while pathological factors covered age, histology status, survival duration, and chemotherapy type. Patients were categorized into young (≤65 years) and elderly ( > 65 years) groups. Statistical analyses, including Kaplan-Meier survival estimates and Cox proportional hazards models, were conducted using R software (v4.4.2) with a significance threshold of p < 0.05. Results: A total of 40,582 glioblastoma patients were analyzed, with 44.1% middle-aged, 46.6% elderly, 57.9% male, 77.6% white, and 87.6% residing in metropolitan areas. Radiation therapy and chemotherapy were administered to 69.6% and 60.1% of patients, respectively. The median survival for younger patients was 19 months (95% CI: 18–20), significantly longer compared to 4 months (95% CI: 4–4) for elderly patients. By race, median survival was 8 months (95% CI: 8–8) for white patients, 9 months (95% CI: 8–10) for black patients, and 9 months (95% CI: 9–10) for Hispanic patients. Patients receiving radiation therapy had a median survival of 12 months (95% CI: 12–12), while those receiving chemotherapy had a median survival of 13 months (95% CI: 13–14).Multivariate analysis identified younger age [HR: 0.56 (0.54–0.58), p < 0.001], metropolitan residence [HR: 0.93 (0.91–0.96), p < 0.001], radiation therapy [HR: 0.55 (0.53–0.56), p < 0.001], and chemotherapy [HR: 0.52 (0.51–0.53), p < 0.001] as protective factors. In contrast, older age [HR: 1.72 (1.68–1.75), p < 0.001], male sex [HR: 1.06 (1.04–1.08), p < 0.001], and white race [HR: 1.09 (1.05–1.14), p < 0.001] were linked to higher mortality risk. Conclusions: Higher survival rates were observed in younger patients, black and Hispanic individuals, and those receiving chemotherapy or radiation. Increased mortality was associated with older age, male sex, and white race. Further research is needed to address disparities and improve glioblastoma outcomes.