Objective:

To evaluate the impact of distance from a National Cancer Institute-designated Comprehensive Cancer Center on overall survival and clinical trial enrollment rates in patients diagnosed with glioblastoma.

Background:

Glioblastoma (GBM) is an aggressive primary brain tumor associated with poor survival. Research shows that patients living in rural areas have poorer outcomes than those in metropolitan areas; however, little is known about how distance between patients and their subspecialist impacts outcomes.

Design/Methods:

Retrospective data was collected from patients with newly diagnosed GBM per the World Health Organization 2021 who received treatment at Huntsman Cancer Institute (HCI) from 2018 to 2022. Distance was evaluated as a categorical (near: 0-25 miles, intermediate: 25-40 miles, far: >40 miles) and continuous variable for analyses. In addition to univariable models, multivariable models adjusting for known prognostic factors were also performed. 

Results:

A total of 167 patients were identified. Baseline characteristics including age, sex, race, and KPS scores were similar across groups. The univariable COX regression model found no significant difference in OS when comparing the near group to the intermediate (p=0.125) and far (p=0.599). However, the multivariable model found poorer OS in the intermediate group that was statistically significant when compared to the near group (HR (95% CI) = 1.55 (1.01, 2.39), p = 0.047). When comparing distances as a continuous variable, patients in the far group had statistically significant lower clinical trial enrollment rates (near group 43%, intermediate 35%, far 18%; p=0.0001).  

Conclusions:

Patients with GBM seeing a neuro-oncologist at our CCC did have a difference in OS as well as clinical trial enrollment when considering distance traveled. Clinical trials are standard of care for patients with GBM; our data provides evidence that distance from a CCC significantly affects trial enrollment, underscoring the importance of ensuring availability of resources for clinical trial participants.