Does gender matter in glioblastoma?

Area of Science:

• Neuro-oncology
• Clinical Neurosurgery
• Radiation Oncology

Background:

• The established clinical outcomes for glioblastoma (GBM) patients receiving radiotherapy with or without chemotherapy are well-documented.
• However, data on the proportion of patients who do not receive these adjuvant treatments post-surgery is limited.
• Investigating reasons for undertreatment in operated GBM patients is crucial.

Purpose of the Study:

• To determine the proportion of glioblastoma patients who do not receive adjuvant treatment after surgery.
• To identify factors associated with the decision to withhold further treatment.
• To analyze the impact of age, gender, Karnofsky Performance Scale (KPS), and surgical approach on treatment receipt and survival.

Main Methods:

• Retrospective review of consecutive glioblastoma patients operated between January 2000 and December 2008.
• Univariate and multivariate analyses were performed to identify predictors of no further treatment.
• Survival analysis was conducted to compare outcomes between genders and treatment groups.

Main Results:

• Out of 216 GBM patients, 55 (25%) did not receive any treatment post-surgery.
• Older age (>=60 years) and lower KPS (<70) were independent predictors for not receiving further treatment.
• Women in the series were older, had lower KPS, and underwent more biopsies, correlating with lower median survival (7.2 months) compared to men (10.4 months) in the overall group.

Conclusions:

• A significant proportion (25%) of glioblastoma patients do not receive adjuvant therapy post-surgery.
• Older age and low KPS are key independent predictors for undertreatment.
• Observed survival disparities between genders in the overall cohort were linked to higher prevalence of poor-prognosis factors in women, which disappeared when treatment was administered.