The association of neighborhood-level deprivation with glioblastoma outcomes: a single center cohort study

Glioblastoma is the most common primary brain malignancy. Though literature has suggested the association of glioblastoma outcomes and socioeconomic status, there is limited evidence regarding the association of neighborhood-level socioeconomic deprivation on glioblastoma outcomes. The aim of this study was to assess the impact of neighborhood-level socioeconomic deprivation on glioblastoma survival. We retrospectively reviewed all adult glioblastoma patients seen at a single institution from 2008 to 2023. Neighborhood deprivation was assessed via Area Deprivation Index (ADI), with higher ADI indicating greater neighborhood socioeconomic disadvantage. Log-rank tests and multivariate cox regression 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. In total, 1464 patients met inclusion criteria. The average age at diagnosis was 60 ± 14 years with a median overall survival of 13.8 months (IQR 13-14.8). The median ADI of the cohort was 66(IQR 46-84). Patients with high neighborhood disadvantage had worse overall survival compared to patients with those without (11.7 vs. 14.8 months, p =.001). In the multivariable model, patients with high neighborhood disadvantage had worse overall survival (HR 1.25, 95%CI 1.09-1.43). To account for changes in WHO guidelines, we implemented the model on patients diagnosed between 2017 and 2023 and findings were consistent (HR 1.26,95%CI 1.01-1.56). We report the first study demonstrating glioblastoma patients with higher neighborhood deprivation have worse survival after controlling for other socioeconomic and biomolecular markers. Neighborhood socioeconomic status may be a prognostic marker for glioblastoma survival.