Abstract
INTRODUCTION: Glioblastoma (GBM) is the most common malignant primary brain tumor in adults with a median survival of 14–16 months. Patient sex plays an important role in GBM as there is a difference in incidence rates and outcome between males and females, which may be attributable to differences in genetic makeup and physiology. OBJECTIVE: Investigate the impact of tumor location and sex differences on survival outcomes based on tumor location, laterality, age, handedness, and extent of resection. METHODS: Patients (129 males and 87 females) who received standard-of-care were included. Analyses were performed using Cox proportional hazard modeling and Kaplan-Meier analysis (log-rank test) to determine which variables impacted patient survival. RESULTS: Overall survival was significantly longer in females in comparison to males (197 days, p = 0.0391). Investigating specific tumor locations, females with a tumor in the left frontal lobe (n = 12) showed a survival advantage compared to females with a right frontal (n = 15) GBM (2853 days, p = 0.0160). Significant differences in median OS were also associated with age. Female patients below the age of fifty showed significantly longer survival (2602 days, n = 84, p<0.001). Interestingly, 70% of IDH1 mutant tumors (n = 10) and 76% of MGMT methylated tumors (n = 26) were found in the frontal lobe and were found in the right hemisphere. CONCLUSION: Together, our results demonstrate that age, sex, and specific brain locations are associated with differences in genetics and survival in GBM.