1015 The Association of Neighborhood-Level Deprivation on Glioblastoma Outcomes: A Single Center Cohort Study

INTRODUCTION: Glioblastoma (GBM) is the most common primary brain malignancy. Despite recent progress in treatments, prognosis for patients remain poor. Recent literature has suggested the association of GBM outcomes and socioeconomic status. However, there is limited evidence regarding the association of neighborhood-level socioeconomic status on GBM outcomes. METHODS: We retrospectively reviewed all adult GBM patients at a single institution from 2008 to 2023. Patient addresses underwent geospatial analysis and Area Deprivation Index (ADI) was extracted. Univariable and multivariable survival analyses were performed. A Cox proportional hazards model 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, 1492 patients met inclusion criteria. The average age at diagnosis was 62 years (Interquartile range[IQR] 52-72) with a median overall survival of 12.1(IQR 5-22) months. The median ADI was 66(IQR 46-84). Patients with high socioeconomic deprivation(ADI>75) were less likely to receive radiotherapy (90% vs 94%, p=.054), chemotherapy (92% vs 96%, p=.03), and had worse overall survival compared to patients with low socioeconomic deprivation (10 vs 13 months,p=.001). In the multivariable model, patients with high ADI had worse overall survival (hazard ratio[HR], 1.42;95% confidence interval[CI], 1.16-1.73,p<.001). To account for changes in WHO guidelines, we implemented the model on patients diagnosed between 2017-2023 and findings were consistent (HR 1.34,95%CI 1.07-1.68,p=.011). CONCLUSIONS: We present the largest study reporting the effect of neighborhood-level socioeconomic status on overall survival of GBM patients. Neighborhood-level socioeconomic status provides the most accurate capture of the patient-level socioeconomic determinants of health. Patients with higher ADI have worse overall survival after controlling for other socioeconomic and clinical variables. These results suggest significant association between neighborhood-level socioeconomic status and overall survival in GBM patients.