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.

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 ¹⁾.