NCOG-26. SOCIOECONOMIC FACTORS AFFECTING SURVIVORSHIP OF GLIOBLASTOMA PATIENTS IN THE PHILIPPINES: A RETROSPECTIVE COHORT STUDY

Abstract BACKGROUND Glioblastoma (GBM) is the most common malignant primary brain tumor in adults worldwide. However, data on the survivorship of glioblastoma for low-middle income countries is sparse. We studied the clinical features, treatment, and survivorship of surgically managed GBM patients at a tertiary referral center in the Philippines over a 5-year period. We determined whether socioeconomic factors such as income level, employment status, marital status and educational attainment affected survival. METHODS A retrospective cohort study within a 5-year period (2015 to 2019) of surgically managed GBM patients in a single center was conducted using chart review and telephone interview. RESULTS A total of 48 cases met the inclusion criteria. Mean age of the cohort was 41 years, with a male predilection (62%). Mean duration of symptoms was 2.8 months. Majority of the tumors were were >5 cm at the time surgery (90%), and involved more than one lobe (40%). Majority (73%) had preoperative KPS ≥70, and underwent subtotal resection (56%). Only 15% (n=7) had adjuvant chemoradiatherapy while another 23% (n=11) had radiotherapy alone. Median overall survival (OS) was 7.6 months (228 days). Most patients had rural residence (56%), low-income (83%), full time employment (79%), married status (73%) and secondary education (44%). Multi-variate analysis showed that only extent of resection (GTR p=0.0297 and STR p=0.0400) were associated with improved survival while widower status (p=0.0116) were significantly more at risk. CONCLUSION Many glioblastoma patients managed at our center in the Philippines presented at an advanced stage in their natural history, with larger tumors and more extensive distribution at time of presentation. After surgery, majority did not receive adjuvant treatment. As such, the median overall survival was less than that reported in published cohorts in developed countries. Extent of resection and marital status were significantly associated with survivorship.