Disparities in Glioblastoma Survival: A Comparative Analysis of Puerto Rican and Mainland U.S. Populations

Introduction: Glioblastomas (GMB) are aggressive brain tumors and despite multimodal therapy, GBM patients face a poor prognosis. Recent studies suggest survival is influenced by geographic location, socioeconomic and genetic factors. We aim to investigate and compare the survival outcomes of GBM patients in Puerto Rico (PUR), mainland US Hispanics (USH) and US Non-Hispanic whites (NHW).

Methods: We utilized data from the Puerto Rico Central Cancer Registry for PUR patients and the Surveillance, Epidemiology, and End Results Program for US mainland patients as part of the Puerto Rico Neoplasm and CNS Tumor Registry (PUNCTURE) protocol. The analysis focused on sex, age, ethnicity, and treatment modality. Kaplan–Meier survival curves estimated 1-, 3-, and 5-year survival outcomes, with group differences assessed via log-rank test.

Results: We identified 857 PUR, 3,887 USH and 25,326 NHW patients from 2010 to 2020. We compared survival percentage PUR/USH/NHW at 1 year 34.7/43.0/38.4% (p < 0.001), 3 years 5.2/12.0/9.2% (p < 0.001), 5 years 1.1/6.4/4.5% (p < 0.001). For patients that underwent standard of care (Surgery+Chemotherapy+radiotherapy), there was no statistically significant difference at 1 year between PUR/USH/NHW (56.8/60.2/56.9% p>0.5). However, this comparison did not remain consistent at 3 or 5 years where USH/NHW outlived PUR (p < 0.02) (3yrs 6.9/16.8/14.0% and 5yrs 0.8/8.7/6.8%)

Conclusion : This comprehensive analysis reveals notable disparities amongst PUR, USH and NHW in glioblastoma survival. Interestingly, PUR patients seem to behave most similarly to NHW patients. Amongst patients receiving triple therapy PUR had decreased survival at 3- and 5- years. Further research is warranted to explore factors contributing to the observed disparities in glioblastoma survival. The findings underscore the importance of addressing these disparities through targeted interventions and healthcare strategies, particularly in the context of demographic variations.