Association between urbanicity and surgical treatment among patients with primary glioblastoma in the United States.
glioblastoma
gross total resection
subtotal resection
surgery
urbanicity
Journal
Neuro-oncology practice
ISSN: 2054-2577
Titre abrégé: Neurooncol Pract
Pays: England
ID NLM: 101640528
Informations de publication
Date de publication:
Jun 2020
Jun 2020
Historique:
entrez:
16
6
2020
pubmed:
17
6
2020
medline:
17
6
2020
Statut:
ppublish
Résumé
Glioblastoma (GB) is the most common and most lethal primary malignant brain tumor. Extent of surgical resection is one of the most important prognostic factors associated with improved survival. Historically, patients living in nonmetropolitan counties in the United States have limited access to optimal treatment and health care services. The aim of this study is to determine whether there is an association between urbanicity and surgical treatment patterns among US patients with primary GB. Cases with histologically confirmed, primary GB diagnosed between 2005 and 2015 were obtained from the Central Brain Tumor Registry of the United States (CBTRUS) in collaboration with the Centers for Disease Control and Prevention, and the National Cancer Institute. Multivariable logistic regression models were constructed to assess the association between urbanicity and receipt of surgical treatment (gross total resection [GTR]/subtotal resection [STR] vs biopsy only/none) and extent of resection (GTR vs STR), adjusted for age at diagnosis, sex, race, US regional division, and primary tumor site. Patients residing in nonmetropolitan counties were 7% less likely to receive surgical treatment (odds ratio [OR] = 0.93, 95% CI: 0.89-0.96, Among US patients with GB, urbanicity is associated with receipt of surgical treatment, but among patients who receive surgery, urbanicity is not associated with extent of resection. These results point to potential differences in access to health care for those in nonmetropolitan areas that warrant further exploration.
Sections du résumé
BACKGROUND
BACKGROUND
Glioblastoma (GB) is the most common and most lethal primary malignant brain tumor. Extent of surgical resection is one of the most important prognostic factors associated with improved survival. Historically, patients living in nonmetropolitan counties in the United States have limited access to optimal treatment and health care services. The aim of this study is to determine whether there is an association between urbanicity and surgical treatment patterns among US patients with primary GB.
METHODS
METHODS
Cases with histologically confirmed, primary GB diagnosed between 2005 and 2015 were obtained from the Central Brain Tumor Registry of the United States (CBTRUS) in collaboration with the Centers for Disease Control and Prevention, and the National Cancer Institute. Multivariable logistic regression models were constructed to assess the association between urbanicity and receipt of surgical treatment (gross total resection [GTR]/subtotal resection [STR] vs biopsy only/none) and extent of resection (GTR vs STR), adjusted for age at diagnosis, sex, race, US regional division, and primary tumor site.
RESULTS
RESULTS
Patients residing in nonmetropolitan counties were 7% less likely to receive surgical treatment (odds ratio [OR] = 0.93, 95% CI: 0.89-0.96,
CONCLUSIONS
CONCLUSIONS
Among US patients with GB, urbanicity is associated with receipt of surgical treatment, but among patients who receive surgery, urbanicity is not associated with extent of resection. These results point to potential differences in access to health care for those in nonmetropolitan areas that warrant further exploration.
Identifiants
pubmed: 32537179
doi: 10.1093/nop/npaa001
pii: npaa001
pmc: PMC7274182
doi:
Types de publication
Journal Article
Langues
eng
Pagination
299-305Subventions
Organisme : NCI NIH HHS
ID : T32 CA009001
Pays : United States
Informations de copyright
© The Author(s) 2020. Published by Oxford University Press on behalf of the Society for Neuro-Oncology and the European Association of Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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