Optimising Outcomes for Glioblastoma through Subspecialisation in a Regional Cancer Centre

Area of Science:

• Neuro-oncology
• Cancer Care Delivery
• Health Services Research

Background:

• Delivering specialized glioblastoma management in rural/regional areas poses challenges to equitable care.
• Existing models often concentrate subspecialized services in high-volume metropolitan centers.
• This disparity can impact the quality of care for patients in underserved regions.

Purpose of the Study:

• To evaluate a novel outsourced neuro-oncology service model for glioblastoma care in a regional center.
• To compare clinical quality indicators and survival outcomes against a large-volume metropolitan center.
• To determine if equivalent quality of care can be achieved in non-metropolitan settings.

Main Methods:

• Retrospective analysis of 352 glioblastoma patients managed under the EORTC-NCIC Protocol.
• Comparison of survival outcomes and clinical quality indicators between a regional cancer center and a metropolitan center.
• Assessment of prognostic factors including age, resection status, ECOG performance, and MGMT methylation.

Main Results:

• Median overall survival was 17 months, influenced by age, resection, ECOG status, and MGMT methylation.
• No significant difference in survival outcomes was observed between regional and metropolitan centers (p=0.35).
• Clinical quality process indicators (trial involvement, repeat craniotomy, bevacizumab, re-irradiation) were comparable across both settings.

Conclusions:

• The developed model of outsourced neuro-oncology subspecialization enables equivalent patient outcomes in regional cancer centers.
• Geographical location does not appear to be a barrier to achieving high-quality glioblastoma care with this model.
• This approach facilitates equitable access to specialized neuro-oncology services, improving care delivery in low-volume areas.