Background: Glioblastoma (GBM) is the most aggressive malignant brain tumour. Having a second or subsequent operation at recurrence may be a positive prognostic factor for survival. Recent studies suggest that socio-demographic variables may influence survival; raising the question whether surgical care differs based on these variables.
Methods: We examined the relationship between selected socio-demographic variables and the number of repeat operations undergone by patients with recurrent GBM. Data from all patients diagnosed with GBM between 2001 and 2011 was obtained from a clinical database at two institutions. The clinical and socio-demographic factors for patients who received one operation were compared to those who had two or more (≥2) operations, using chi-square analyses to determine statistical differences between groups. Socio-economic status was measured using the Index of Relative Socio-economic Advantage and Disadvantage (IRSAD) scores.
Results: Of 553 patients, 449 (81%) had one operation and 104 (19%) had ≥2 operations. Patients who had ≥2 operations were significantly younger (median 55 years versus 64 years, p<0.001), less likely to have multifocal (p=0.043) or bilateral (p=0.037) disease and more likely to have initial macroscopic resection (p=0.006), than those who had only one operation. Socioeconomic status did not significantly differ between the groups (p=0.31). Similarly, there was no significant difference between the number of operations in patients from regional versus city residence and public versus private hospital.
Conclusion: There were no significant differences between the socio-demographic status of patients who had multiple resections for recurrent GBM and those who had only one operation. This is reassuring in that it suggests that similar surgical management options are available for patients regardless of their socio-demographic background.