Social determinants of health and survival on Brazilian patients with glioblastoma: a retrospective analysis of a large populational database

Abstract Background The majority of patients diagnosed with glioblastoma develop recurrent disease resulting in poor prognoses. The current study aimed to determine the survival rates of patients diagnosed with glioblastoma in Brazil accounting for the influence of age, treatment modalities, public and private practices, and educational level using a population-based national database. Methods Patients diagnosed with glioblastoma from 1999-2020 were identified from The Fundacao Oncocentro de Sao Paulo database to create a retrospective cohort. Patients were described according to age, education level treatment modalities and medical practice. In a Cox proportional hazards model, controlled for confounding factors for overall survival, the hazard ratio and 95% CI of overall survival in adults was evaluated. Findings A total of 4,511 patients were included. The median lengths of survival for patients treated in the public and private settings were 8 and 17 months (p Interpretation Public practice, older patients, less intensive treatment, and lower educational level were associated with worse survival outcomes in Brazilian glioblastoma patients.