Epidemiology of glioblastoma in Pakistan: a secondary analysis of the Pakistan Brain Tumor Epidemiology Study (PBTES)

Purpose: The incidence and outcomes of glioblastoma (GBM) patients in Pakistan remain unassessed owing to a lack of cancer registries and the absence of population-based studies. For any specific population-based oncological intervention, epidemiology must be studied. Therefore, this study aims to examine the epidemiological characteristics of glioblastoma patients in Pakistan, as part of a secondary analysis of a nationwide epidemiological study. Methods: Data comprising of sociodemographic, tumor and treatment characteristics of 2750 patients from the Pakistan Brain Tumor Epidemiology Study were extracted and analyzed for cases between January 1, 2019, and December 31, 2019. Chi-square tests identified outcome and treatment differences. Data analysis was performed using SPSS version 26. Results: A total of 260 GBM cases were analyzed, with a mean diagnosis age of 45 years. Males accounted for 68.8%. Most patients were from a middle- (39.6%) or lower-income (42.7%) socioeconomic background and received care from a public institution (63.8%). GBM tumors were mainly located in the frontal lobe with similar proportions of right and left laterality. A median distance of 119 km was traveled for oncological care, and the mean time to surgery from the initial radiological diagnosis was 72 days. Gross total resection was achieved in 47.3% of first surgeries, with 23 reoperations for recurrence. At the end of the study period, 33% of the GBM cohort was recorded as alive with 47% being lost to follow-up. Conclusion: Our analysis is the first population-based analysis of GBM in Pakistan. This epidemiologic study can serve as a basis for future research in etiology, treatment, and outcomes for glioblastoma in the Pakistani population.