Department of Neurology and Neurosurgery, Baylor College of Medicine, One Baylor Plaza, MS NB302, Houston, TX, 77030, USA.
Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Unit 431, 1515 Holcombe Blvd, Houston, TX, 77030-4009, USA.
J Neurooncol. 2019 Apr;142(2):365-374. doi: 10.1007/s11060-019-03108-z. Epub 2019 Jan 22.
Examine the potential effects of health disparities in survival of glioblastoma (GB) patients.
We conducted a retrospective chart review of newly diagnosed GB patients from 2000 to 2015 at a free standing dedicated cancer center (MD Anderson Cancer Center-MDACC) and a safety net county hospital (Ben Taub General Hospital-BT) located in Houston, Texas. We obtained demographics, insurance status, extent of resection, treatments, and other known prognostic variables (Karnofsky Score-KPS) to evaluate their role on overall GB survival (OS).
We identified 1073 GB patients consisting of 177 from BT and 896 from MDACC. We found significant differences by ethnicity, insurance status, KPS at diagnosis, extent of resection, and percentage of patients receiving standard of care (SOC) between the two centers. OS was 1.64 years for MDACC patients and 1.24 years for BT patients (p < 0.0176). Only 81 (45.8%) BT patients received SOC compared to 577 (64%) of MDACC patients (p < 0.0001). However, there was no significant difference in OS for patients who received SOC, 1.84 years for MDACC patients and 1.99 years for BT patients (p < 0.4787). Of the 96 BT patients who did not receive SOC, 29 (30%) had KPS less than 70 at time of diagnosis and 77 (80%) lacked insurance.
GB patients treated at a safety net county hospital had similar OS compared to a free standing comprehensive cancer center when receiving SOC. County hospital patients had poorer KPS at diagnosis and were often lacking health insurance affecting their ability to receive SOC.
研究健康差异对胶质母细胞瘤（GB）患者生存的潜在影响。
我们对 2000 年至 2015 年期间在德克萨斯州休斯顿的一家独立癌症中心（MD 安德森癌症中心-MDACC）和一家保障性县级医院（本陶布综合医院-BT）新诊断的胶质母细胞瘤患者进行了回顾性图表审查。我们获得了人口统计学、保险状况、切除范围、治疗方法和其他已知预后变量（Karnofsky 评分-KPS），以评估它们对总体 GB 生存（OS）的影响。
我们共确定了 1073 名 GB 患者，其中 177 名来自 BT，896 名来自 MDACC。我们发现，两个中心在种族、保险状况、诊断时的 KPS、切除范围以及接受标准治疗（SOC）的患者比例方面存在显著差异。MDACC 患者的 OS 为 1.64 年，BT 患者的 OS 为 1.24 年（p<0.0176）。只有 81 名（45.8%）BT 患者接受了 SOC，而 MDACC 患者中有 577 名（64%）接受了 SOC（p<0.0001）。然而，接受 SOC 的患者的 OS 没有显著差异，MDACC 患者的 OS 为 1.84 年，BT 患者的 OS 为 1.99 年（p<0.4787）。在未接受 SOC 的 96 名 BT 患者中，29 名（30%）患者在诊断时的 KPS 小于 70，77 名（80%）患者没有保险。
当接受 SOC 治疗时，在保障性县级医院治疗的 GB 患者的 OS 与独立综合性癌症中心相似。县级医院患者在诊断时的 KPS 较差，且往往缺乏医疗保险，这影响了他们接受 SOC 的能力。
