====== Philippines ======


The Philippines is an archipelagic country in [[Southeast Asia]]. Situated in the western Pacific Ocean, it consists of about 7,641 islands that are categorized broadly under three main geographical divisions from north to south: Luzon, Visayas, and Mindanao. The capital city of the Philippines is [[Manila]] and the most populous city is Quezon City, both part of Metro Manila.

Division of Neurosurgery, Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines [[Manila]], Philippines.


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Data on the [[glioblastoma outcome]] of patients in low- and middle-income countries is sparse. Hong et al. determined whether socioeconomic factors such as marital status, place of residence, educational attainment, employment status, and [[income]] affected survival. A retrospective cohort study of surgically managed Glioblastoma patients (n = 48) in a single-center over a five-year period was conducted using chart review and telephone interviews. The mean age was 41 years, with a male predilection (62%). Most patients were married (73%), employed full-time (79%), resided in a rural location (56%), completed secondary education (44%), and had a low income (83%). Most of the tumors were > 5 cm at the time of diagnosis (90%) and involved more than one lobe (40%). The majority underwent subtotal resection (56%). Only 15% (n = 7) had adjuvant chemoradiation while 23% (n = 11) had radiotherapy alone. The median overall survival was 7.6 months. Multivariate analysis showed that [[extent of resection]] (gross total resection, p = 0.0033; subtotal resection, p = 0.0069) and adjuvant treatment (p = 0.0254) were associated with improved survival, while low income (p = 0.0178) and educational (p = 0.0206) levels and part-time employment (p = 0.0063) were associated with decreased [[survival]]. Many Glioblastoma patients at our center presented at an advanced stage in their [[natural history]], and the majority (62%) did not receive [[adjuvant]] [[treatment]] after surgery. As such, the median [[overall survival]] was less than that reported in developed countries. Of the socioeconomic factors analyzed, low income and educational levels, and part-time employment were negatively associated with survivorship
((Hong MAC, Omar AT, Khu KJO. Socioeconomic factors affecting survivorship of glioblastoma patients in the Philippines. J Clin Neurosci. 2022 Feb 9;98:89-95. doi: 10.1016/j.jocn.2022.02.007. Epub ahead of print. PMID: 35151062.)).