Sociodemographic Influence on Clinical Presentation of High-Grade Gliomas

Overview

This multi-institutional retrospective study of 317 high-grade glioma (HGG) patients revealed significant differences in clinical presentation based on race and ethnicity. White patients were diagnosed at older ages and more frequently exhibited cognitive deficits, while Black and Hispanic patients presented more often with severe symptoms such as syncope and seizures, respectively.

Background

High-grade gliomas (HGG) are aggressive brain tumors classified as WHO grade III or IV, with poor prognosis and median survival ranging from 12 to 72 months depending on grade. Clinical symptoms vary widely and include generalized signs like headaches and seizures, as well as focal neurological deficits. Incidence and outcomes of gliomas differ by ancestry and sociodemographic factors, but the influence of these factors on clinical presentation has been understudied. This study aims to elucidate how race and ethnicity impact the initial clinical features of HGG.

Data Highlights

Key Findings

• White patients were diagnosed at an older age compared to Black and Hispanic patients.
• White patients more frequently presented with cognitive deficits at diagnosis.
• Black patients had a higher likelihood of presenting with syncope, a severe and life-threatening symptom.
• Hispanic patients were more likely to present with seizures compared to other groups.
• White patients showed less frequent midline shift and mass effect on imaging studies.
• Social vulnerability indices indicated disparities but did not fully explain differences in clinical presentation.

Clinical Implications

Clinicians should be aware that sociodemographic factors influence the initial clinical presentation of HGG, which may affect timely diagnosis and management. Recognizing that Black and Hispanic patients may present with more acute, severe symptoms could prompt earlier intervention. Additionally, tailored diagnostic vigilance is warranted given the older age and cognitive symptom predominance in White patients.

Conclusion

This study highlights significant sociodemographic disparities in the clinical features of high-grade gliomas at diagnosis, underscoring the need for further research into underlying causes and their impact on treatment outcomes.

References

1. Multiple Sources 1-24 -- Influence of Sociodemographic Factors on Clinical Features of High-Grade Gliomas