Initial care and outcome of glioblastoma multiforme patients in 2 diverse health care scenarios in Brazil: does public versus private health care matter?

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dc.contributor.authorMaia Loureiro, Luiz Victor
dc.contributor.authorPontes, Luciola de Barros
dc.contributor.authorCallegaro-Filho, Donato
dc.contributor.authorKoch, Ludmila de Oliveira
dc.contributor.authorWeltman, Eduardo
dc.contributor.authorVictor, Elivane da Silva
dc.contributor.authorSantos, Adrialdo Jose [UNIFESP]
dc.contributor.authorRodrigues Borges, Lia Raquel [UNIFESP]
dc.contributor.authorSegreto, Roberto Araujo [UNIFESP]
dc.contributor.authorFleury Malheiros, Suzana Maria [UNIFESP]
dc.contributor.institutionHosp Israelita Albert Einstein
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.date.accessioned2016-01-24T14:37:28Z
dc.date.available2016-01-24T14:37:28Z
dc.date.issued2014-07-01
dc.description.abstractThe aim of this study was to describe the epidemiological and survival features of patients with glioblastoma multiforme treated in 2 health care scenarios-public and private-in Brazil.We retrospectively analyzed clinical, treatment, and outcome characteristics of glioblastoma multiforme patients from 2003 to 2011 at 2 institutions.The median age of the 171 patients (117 public and 54 private) was 59.3 years (range, 18-84). the median survival for patients treated in private institutions was 17.4 months (95% confidence interval, 11.1-23.7) compared with 7.1 months (95% confidence interval, 3.8-10.4) for patients treated in public institutions (P < .001). the time from the first symptom to surgery was longer in the public setting (median of 64 days for the public hospital and 31 days for the private institution; P = .003). the patients at the private hospital received radiotherapy concurrent with chemotherapy in 59.3% of cases; at the public hospital, only 21.4% (P < .001). Despite these differences, the institution of treatment was not found to be an independent predictor of outcome (hazard ratio, 1.675; 95% confidence interval, 0.951-2.949; P = .074). the Karnofsky performance status and any additional treatment after surgery were predictors of survival. A hazard ratio of 0.010 (95% confidence interval, 0.003-0.033; P < .001) was observed for gross total tumor resection followed by radiotherapy concurrent with chemotherapy.Despite obvious disparities between the hospitals, the medical assistance scenario was not an independent predictor of survival. However, survival was directly influenced by additional treatment after surgery. Therefore, increasing access to resources in developing countries like Brazil is critical.en
dc.description.affiliationHosp Israelita Albert Einstein, BR-05652900 São Paulo, Brazil
dc.description.affiliationUniversidade Federal de São Paulo, Escola Paulista Med, São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Escola Paulista Med, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.format.extent999-1005
dc.identifierhttp://dx.doi.org/10.1093/neuonc/not306
dc.identifier.citationNeuro-oncology. Cary: Oxford Univ Press Inc, v. 16, n. 7, p. 999-1005, 2014.
dc.identifier.doi10.1093/neuonc/not306
dc.identifier.issn1522-8517
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/37892
dc.identifier.wosWOS:000338126100012
dc.language.isoeng
dc.publisherOxford Univ Press Inc
dc.relation.ispartofNeuro-oncology
dc.rightsinfo:eu-repo/semantics/openAccess
dc.rights.licensehttp://www.oxfordjournals.org/access_purchase/self-archiving_policyb.html
dc.subjectclinical practice patternsen
dc.subjectdeveloping countriesen
dc.subjectglioblastomaen
dc.subjectinsuranceen
dc.subjectsurvivalen
dc.titleInitial care and outcome of glioblastoma multiforme patients in 2 diverse health care scenarios in Brazil: does public versus private health care matter?en
dc.typeinfo:eu-repo/semantics/article
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