Neighborhood Socioeconomic Disadvantage Is Associated with Overall Survival in IDH-Mutant Glioma

Abstract Background Neighborhood socioeconomic disadvantage influences outcomes across many cancer types, yet its role in IDH-mutant gliomas remains unexplored. Because these tumors have a prolonged disease course, they may have unique vulnerabilities to socioeconomic disparity. We examined the association between the Area Deprivation Index (ADI) and clinical outcomes in patients with IDH-mutant gliomas. Methods We conducted a retrospective cohort study of 193 adults with histologically and molecularly confirmed IDH-mutant gliomas per the WHO 2021 criteria, who were all treated at a single academic center from 1994-2025. State ADI deciles were derived from patients’ ZIP codes at diagnoses. Primary outcomes were overall survival (OS) and time to next intervention (TTNI) or death. We used univariable and multivariable survival models, adjusting for age at diagnosis, extent of resection, and histology. Results The median follow up was 7.7 years and median OS was 18.7 years. Patients from high-ADI neighborhoods (state decile greater than or equal to four) had significantly higher mortality than patients from low-ADI neighborhoods (HR = 3.02, 95% CI: 1.43--6.36; p = .004). ADI was not significantly associated with TTNI in primary analysis (HR = 1.52, p = .06), though a repeated measures sensitivity analysis demonstrated a significant association (HR = 1.70, p = .01). Oligodendroglioma histology and greater extent of resection were protective for both outcomes. Conclusions Neighborhood socioeconomic disadvantage is associated with worse overall survival in IDH-mutant glioma after adjusting for age, extent of resection, and histology. Ensuring equitable access to longitudinal care across socioeconomic strata may mitigate survival disparities in this population.