Abstract
PURPOSE: Glioblastoma is the most common primary brain malignancy. Though literature has suggested the association of glioblastoma outcomes and socioeconomic status, there is limited evidence regarding the association of neighborhood-level socioeconomic deprivation on glioblastoma outcomes. The aim of this study was to assess the impact of neighborhood-level socioeconomic deprivation on glioblastoma survival. METHODS: We retrospectively reviewed all adult glioblastoma patients seen at a single institution from 2008 to 2023. Neighborhood deprivation was assessed via Area Deprivation Index (ADI), with higher ADI indicating greater neighborhood socioeconomic deprivation. Log-rank tests and multivariate cox regression was used to assess the effect of ADI and other socioeconomic variables while controlling for a priori selected clinical variables with known relevance to survival. RESULTS: In total, 1464 patients met inclusion criteria. The average age at diagnosis was 60 ± 14 years with a median overall survival of 13.8 months (IQR 13-14.8). The median ADI of the cohort was 66(IQR 46-84). Patients with high ADI had worse overall survival compared to patients with low ADI (11.7 vs 14.8 months, p=.001). In the multivariable model, patients with high ADI had worse overall survival (HR 1.25, 95%CI 1.09-1.43). To account for changes in WHO guidelines, we implemented the model on patients diagnosed between 2017-2023 and findings were consistent (HR 1.26,95%CI 1.01-1.56). CONCLUSION: We report the first study demonstrating glioblastoma patients with higher neighborhood deprivation have worse survival after controlling for other socioeconomic and biomolecular markers. Neighborhood socioeconomic status may be a prognostic marker for glioblastoma survival.