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Background <p>Socioeconomic deprivation influences outcomes across numerous neurosurgical conditions, yet its impact on glioma remains poorly characterised. This study examined whether area-level deprivation, measured by the Index of Multiple Deprivation (IMD), was associated with survival and perioperative outcomes following glioma resection.</p> Methods <p>This retrospective cohort study analysed 199 adults undergoing surgical resection for WHO Grade 2–4 gliomas at a UK tertiary neurosurgical centre between 2010 and 2024. Patients were stratified by IMD quintile. Primary outcomes were overall survival (OS) and progression-free survival (PFS). Multivariable Cox regression models adjusted for age, molecular markers (IDH mutation, MGMT methylation), and preoperative functional status, with separate analyses by tumour grade.</p> Results <p>Extent of resection and receipt of adjuvant therapy did not differ significantly across IMD quintiles (extent of resection <i>p</i> = 0.123). IMD quintile was not associated with OS in any grade. However, in Grade 4 gliomas (<i>n</i> = 122; <i>n</i> = 88 for complete case analysis), higher socioeconomic status was associated with longer PFS (HR 0.72 per quintile increase, 95% CI 0.55–0.94, <i>p</i> = 0.017), representing a 28% reduction in progression risk per quintile. No associations were observed for Grade 2 or 3 tumours, nor for perioperative complications, reoperation rates, or functional decline.</p> Conclusions <p>Socioeconomic deprivation was associated with earlier disease progression in glioblastoma following adjustment for established prognostic factors and extent of resection. The absence of perioperative disparities and equitable treatment initiation suggests inequalities emerge during longitudinal oncological care rather than surgical treatment. These findings highlight the need for healthcare systems to address socioeconomic barriers in neuro-oncology pathways.</p>

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Socioeconomic disparities in glioma outcomes: a grade-specific analysis

  • 期刊论文

  • 发表日期：

    2026年2月3日

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  • Joshua J. Hon,
  • Helena Akbarzadeh Mostaghbal,
  • Yash Akkara,
  • Joe M. Das

摘要

Background

Socioeconomic deprivation influences outcomes across numerous neurosurgical conditions, yet its impact on glioma remains poorly characterised. This study examined whether area-level deprivation, measured by the Index of Multiple Deprivation (IMD), was associated with survival and perioperative outcomes following glioma resection.

Methods

This retrospective cohort study analysed 199 adults undergoing surgical resection for WHO Grade 2–4 gliomas at a UK tertiary neurosurgical centre between 2010 and 2024. Patients were stratified by IMD quintile. Primary outcomes were overall survival (OS) and progression-free survival (PFS). Multivariable Cox regression models adjusted for age, molecular markers (IDH mutation, MGMT methylation), and preoperative functional status, with separate analyses by tumour grade.

Results

Extent of resection and receipt of adjuvant therapy did not differ significantly across IMD quintiles (extent of resection p = 0.123). IMD quintile was not associated with OS in any grade. However, in Grade 4 gliomas (n = 122; n = 88 for complete case analysis), higher socioeconomic status was associated with longer PFS (HR 0.72 per quintile increase, 95% CI 0.55–0.94, p = 0.017), representing a 28% reduction in progression risk per quintile. No associations were observed for Grade 2 or 3 tumours, nor for perioperative complications, reoperation rates, or functional decline.

Conclusions

Socioeconomic deprivation was associated with earlier disease progression in glioblastoma following adjustment for established prognostic factors and extent of resection. The absence of perioperative disparities and equitable treatment initiation suggests inequalities emerge during longitudinal oncological care rather than surgical treatment. These findings highlight the need for healthcare systems to address socioeconomic barriers in neuro-oncology pathways.