Impact of remoteness and rurality on the treatment and survival of patients with glioblastoma in the north of Scotland
Abstract
Background: The geographical catchment area served by the Neurosurgical Unit in Aberdeen, Scotland is the largest in the United Kingdom. We examined whether a distance-decay effect on survival exists for patients diagnosed with glioblastoma, who have to travel substantial distances for neurosurgical and oncological treatment in the north of Scotland. Methods: Electronic medical records of adult patients with glioblastoma, referred for treatment between 2007 and 2018, who underwent surgical resection were reviewed. Travel time by car (as a measure of distance travelled) was calculated from the patients’ home to their general practice (GP) and to their main neuro-oncological centre. Results: There were 122 patients; 71 (58.2%) were male and the mean age was 57.8 years. The urban-rural split was 61.5% and 38.5%, respectively. Median driving time to the neuro-oncological centre was 36 min and to the GP this was 6 min. Most patients underwent either sub-total (49.6%) or gross total (46.3%) surgical resection. Post-operative treatments included: radiotherapy only (15.6%), chemotherapy only (6.6%), and chemotherapy with radiotherapy (63.1%). Temozolomide was used in 70.5% of patients. Seventeen patients did not receive any post-operative chemo-radiotherapy. The median survival time was 345 days. There was no statistically significant association between distance travelled and survival time in days. MGMT methylation status, extent of resection, Charlson co-morbidity index and treatment received significantly affected survival. Conclusions: There was no evidence of disadvantage on survival time for patients living further from their neuro-oncological centre compared to those who live nearer.
Publication Date
2024-02-25
Publication Title
World Neurosurgery: X
Volume
22
ISSN
2590-1397
Keywords
Glioblastoma, Health services Accessibility, Neurosurgery
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
Recommended Citation
Veljanoski, D., Barlas, R., Jamjoom, A., Walkden, J., Horgan, G., Moleron, R., Myint, P., & Giamouriadis, A. (2024) 'Impact of remoteness and rurality on the treatment and survival of patients with glioblastoma in the north of Scotland', World Neurosurgery: X, 22. Available at: 10.1016/j.wnsx.2024.100331" >https://doi.org/10.1016/j.wnsx.2024.100331
