Effect of health disparities on overall survival of patients with glioblastoma

Jacob J. Mandel, Michael Youssef, Jooyeon Nam, Akash J. Patel, Ali Jalali, Ethan B. Ludmir, Diane Liu, Jimin Wu, Georgina Armstrong, Jason Huse, Melissa Bondy, John F. de Groot

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Background: Examine the potential effects of health disparities in survival of glioblastoma (GB) patients. Methods: We conducted a retrospective chart review of newly diagnosed GB patients from 2000 to 2015 at a free standing dedicated cancer center (MD Anderson Cancer Center—MDACC) and a safety net county hospital (Ben Taub General Hospital—BT) located in Houston, Texas. We obtained demographics, insurance status, extent of resection, treatments, and other known prognostic variables (Karnofsky Score—KPS) to evaluate their role on overall GB survival (OS). Results: We identified 1073 GB patients consisting of 177 from BT and 896 from MDACC. We found significant differences by ethnicity, insurance status, KPS at diagnosis, extent of resection, and percentage of patients receiving standard of care (SOC) between the two centers. OS was 1.64 years for MDACC patients and 1.24 years for BT patients (p < 0.0176). Only 81 (45.8%) BT patients received SOC compared to 577 (64%) of MDACC patients (p < 0.0001). However, there was no significant difference in OS for patients who received SOC, 1.84 years for MDACC patients and 1.99 years for BT patients (p < 0.4787). Of the 96 BT patients who did not receive SOC, 29 (30%) had KPS less than 70 at time of diagnosis and 77 (80%) lacked insurance. Conclusions: GB patients treated at a safety net county hospital had similar OS compared to a free standing comprehensive cancer center when receiving SOC. County hospital patients had poorer KPS at diagnosis and were often lacking health insurance affecting their ability to receive SOC.

Original languageEnglish (US)
Pages (from-to)365-374
Number of pages10
JournalJournal of Neuro-Oncology
Volume142
Issue number2
DOIs
StatePublished - Apr 15 2019
Externally publishedYes

Keywords

  • Glioblastoma
  • Health disparities
  • Insurance
  • Overall survival
  • Race

ASJC Scopus subject areas

  • Oncology
  • Neurology
  • Clinical Neurology
  • Cancer Research

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