Economic income and survival in patients affected by glioblastoma: A systematic review and meta-analysis

Background Within socioeconomic variables, economic income has been associated with the prognosis of patients with glioblastoma. However, studies investigating this issue provided conflicting results.Methods We carried out a systematic review and meta-analysis of studies investigating the correlation between economic income and survival in patients with glioblastoma. The inverse variance technique for hazard ratio (HR) assessment has been employed in reporting the random effect model.Results We included 12 studies for a total of 143 303 GBM patients (67 463 with high economic income, and 25 679 with low economic income). In the overall analysis, lower economic income resulted in poorer survival (pooled HR 1.09, 95% CI: 1.02-1.17, I2 = 64%). Variables like the type of Health Care System (public, private, or mixed) and the time in which patients have been treated (pre or post-EORTC-NCIC trial 22981/26981, CE.3 protocol advent) did not modify survival on pooled analysis.Conclusions Economic conditions and income influence the prognosis of patients with glioblastoma. A better understanding of the modifiable barriers leading to treatment disparities in more disadvantaged patients is warranted to make equal oncological care.