October 16-21, 2010 • San Francisco • California

1. October 16-21, 2010 • San Francisco • California Socioeconomics factors interference in the prognosis for glioblastoma multiforme José Carlos Lynch • Claudia Escosteguy Celestino Pereira • Leonardo Welling Ricardo Andrade • Alessandra Pereira Brazil • Rio de Janeiro

2. Socioeconomics factors interference in the prognosis for Glioblastoma Multiforme Introduction This study aims to compare the survival of Glioblastoma Multiforme (GBM) patients operated on at Hospital dos Servidores do Estado (public hospital) with that of patients operated on at the D’Or hospitals (private hospital).

3. Socioeconomics factors interference in the prognosis for Glioblastoma Multiforme Method 79 patients with Glioblastoma Multiforme Period 1986 – 2006 45 patients operated on HSE (public hospital) 21 patients operated onRede D’Or (private hospital))

4. Socioeconomics factors interference in the prognosis for Glioblastoma Multiforme Accumulated survival probability based on patients with Glioblastoma Multiforme operated on in public or private hospitals (Kaplan-Meier method) P=0.005 This finding was statistically significative P = 0.005

5. Socioeconomics factors interference in the prognosis for Glioblastoma Multiforme Accumulated survival probability based on KPS of the patients with Glioblastoma Multiforme (Kaplan-Meier method) P=0.0001 This finding was statistically significative Public KPS >70: 53.3% of patients PrivateKPS>70: 100 % of patients Time between diagnose and surgery: Public: 2.75 months Private: 1.6 months

6. Socioeconomics factors interference in the prognosis for Glioblastoma Multiforme Accumulated survival probability based on the extent of tumor resection in patients with glioblastomamultiforme(Kaplan-Meiermethod) P=0.057 This finding was not statistically significative Extent of tumor resection Total public: 48.9% Total private:71.4%

7. Socioeconomics factors interference in the prognosis for Glioblastoma Multiforme Accumulated survival probability based on radiotherapy performance in patients with GlioblastomaMultiforme(Kaplan-Meier method) P < 0.0001 This finding was Statistically significative Completed RT Public: 60% Private: 90.5% Distance between the patient’s residence and the place where RT was done Public: 21km Private: 7km Development Human Index (DHI) Private: 0.970 – 0.938 Public: 0.798 – 0.711

8. Socioeconomics factors interference in the prognosis for Glioblastoma Multiforme Conclusion 1. The present study revealed that the survival of patients in private group was statistically superior to that of patients in public group. Average survival of private patients is 11.9 vs 7.7 months in public patients. 2. The two analyzed groups come from different socio-economical background. The patients from public group have a low level of education and low family income; the prognostic factors such as KPS and RT performance were statistically worse in these patients. 3. Our study move towards proving the hypothesis that socioeconomic factors contribute to influence negatively the survival of the patients treated at public hospitals, due to late diagnosis, worst neurological status and the delay in treatment.

9. Socioeconomics factors interference in the prognosis for Glioblastoma Multiforme Conclusion 4. The data shown above corroborate what is already acknowledged by many Brazilian authorities, that is, the need to increase public investment in health. Presently, the per capita health public investment is inferior to what is é commended by World Health Organization (WHO).