Disparities in health care determine prognosis in newly diagnosed glioblastoma

Neurosurgical Focus
Ankush ChandraManish K Aghi

Abstract

OBJECTIVE Glioblastoma (GBM) is an aggressive brain malignancy with a short overall patient survival, yet there remains significant heterogeneity in outcomes. Although access to health care has previously been linked to impact on prognosis in several malignancies, this question remains incompletely answered in GBM. METHODS This study was a retrospective analysis of 354 newly diagnosed patients with GBM who underwent first resection at the authors' institution (2007-2015). RESULTS Of the 354 patients (median age 61 years, and 37.6% were females), 32 (9.0%) had no insurance, whereas 322 (91.0%) had insurance, of whom 131 (40.7%) had Medicare, 45 (14%) had Medicaid, and 146 (45.3%) had private insurance. On average, insured patients survived almost 2-fold longer (p < 0.0001) than those who were uninsured, whereas differences between specific insurance types did not influence survival. The adjusted hazard ratio (HR) for death was higher in uninsured patients (HR 2.27 [95% CI 1.49-3.33], p = 0.0003). Age, mean household income, tumor size at diagnosis, and extent of resection did not differ between insured and uninsured patients, but there was a disparity in primary care physician (PCP) status-none of the uninsured patients had PCPs...Continue Reading

References

Nov 1, 1994·Journal of Clinical Epidemiology·M CharlsonJ Gold
Aug 19, 1999·Journal of the National Cancer Institute·R G RoetzheimJ P Krischer
Dec 16, 2000·The Journal of the American Board of Family Practice·J M FerranteR G Roetzheim
Oct 7, 2003·The Journal of Rural Health : Official Journal of the American Rural Health Association and the National Rural Health Care Association·Robert G BrooksArt Clawson
Mar 11, 2005·The New England Journal of Medicine·Roger StuppUNKNOWN National Cancer Institute of Canada Clinical Trials Group
Apr 16, 2005·Neuro-oncology·Jean-Blaise WasserfallenRoger Stupp
Nov 3, 2011·Journal of Neuro-oncology·Derek R Johnson, Brian Patrick O'Neill
Nov 21, 2012·Archives of Surgery·Eric N MominAlfredo Quiñones-Hinojosa
May 4, 2013·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Kathryn M FieldMark A Rosenthal
May 15, 2013·Journal of Neuro-oncology·Erin M SiegelKathleen M Egan
May 25, 2013·Asia-Pacific Journal of Clinical Oncology·Kathryn Maree FieldKate Drummond
Jun 19, 2013·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Y SiaK Drummond
Jun 19, 2013·The Journal of Surgical Research·Jillian K SmithJennifer F Tseng
Nov 10, 2013·Journal of the American Board of Family Medicine : JABFM·Rose C MalyAmardeep Thind
Mar 14, 2014·JAMA Surgery·Bradley N ReamesAmir A Ghaferi
Mar 22, 2014·International Journal of General Medicine·Aristofanis Gikas, John K Triantafillidis
Jun 4, 2014·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Ayal A AizerPaul L Nguyen
Aug 6, 2014·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Gary V WalkerUsama Mahmood
Nov 26, 2014·Cancer Causes & Control : CCC·Alyx B PorterDerek R Johnson
Dec 3, 2014·Cancer Epidemiology·David GaistHenrik Toft Sørensen
Jul 28, 2015·Neurosurgery·Adeeb DerakhshanMichael P Steinmetz
Sep 4, 2015·Journal of Neuro-oncology·Samiul MuquitSurajit Basu
May 25, 2016·Surgical Neurology International·Rebecca A KaslLola B Chambless
Oct 19, 2016·European Journal of Gastroenterology & Hepatology·John K TriantafillidisApostolos Papalois
Nov 20, 2016·Journal of Neuro-oncology·Jacob Y ShinAidnag Z Diaz
May 6, 2017·Neurosurgery·Patrick M FlaniganManish K Aghi
May 12, 2017·Current Oncology·J EasleyUNKNOWN Canadian Team to Improve Community-Based Cancer Care Along the Continuum
Jan 26, 2018·International Journal of MCH and AIDS·Gopal K SinghIvy P Vedamuthu

❮ Previous
Next ❯

Citations

Jan 24, 2019·Journal of Neuro-oncology·Jacob J MandelJohn F de Groot
May 1, 2020·Journal of Neuro-oncology·Ramin A MorshedShawn L Hervey-Jumper
Aug 9, 2020·Neuro-oncology Practice·Aaron BowerRoy E Strowd
Jan 25, 2021·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Alicia TosoniAlba Ariela Brandes
Mar 24, 2021·Journal of Neuro-oncology·Quinn T OstromJill S Barnholtz-Sloan
Apr 9, 2021·American Society of Clinical Oncology Educational Book·Alyx B PorterShawn Hervey-Jumper

❮ Previous
Next ❯

Methods Mentioned

BETA
biopsy

Software Mentioned

JMP

Related Concepts

Related Feeds

Cancer Disparities

Cancer disparities refers to differences in cancer outcomes (e.g., number of cancer cases, related health complications) across population groups.

Cardiomyopathy

Cardiomyopathy is a disease of the heart muscle, that can lead to muscular or electrical dysfunction of the heart. It is often an irreversible disease that is associated with a poor prognosis. There are different causes and classifications of cardiomyopathies. Here are the latest discoveries pertaining to this disease.

Cancer Stem Cells in Glioblastoma

Glioblastoma is the most common and aggressive type of brain tumor. It contains a population of tumor initiating stem cell-like cells known as cancer stem cells. Investigations are ongoing into these cancer stem cells found in these solid tumors which are highly resistance to treatment. Here is the latest research on cancer stem cells in glioblastoma.