Do clinical outcomes in individuals with malignant gliomas differ between sexes?

Introduction: Sex-related differences in the epidemiology of malignant gliomas are acknowledged; however, information regarding their clinical characteristics and outcomes after surgery is limited.

Research question: To identify sex-specific differences of all patients with high-grade glioma at our institution and assessed clinical outcomes and prognostic factors.

Material and methods: This single-center study included those who underwent surgery for malignant gliomas between 2010 and 2020. Categorical, normally distributed, and skewed continuous variables were compared between men and women using the chi-square test, independent samples t-test, and Mann-Whitney U test, respectively. Survival was calculated using the log-rank and Kaplan-Meier methods.

Results: In total, 621 patients with WHO grade IV gliomas were identified (370 (59.58%) male). Men were significantly younger, underwent surgery faster after imaging diagnosis, and had a slightly higher surgical complications incidence than women. Women reported a worse preoperative performance status. Multivariate analysis showed that sex did not affect survival, surgical complications, nicotine or alcohol abuse, or preoperative tumor volume. Age, Karnofsky performance status, neurosurgical resection, and adjuvant radiotherapy with temozolomide showed a survival advantage.

Discussion and conclusions: Men are diagnosed with malignant glioma at a younger age than women; however, no advantage in clinical outcomes was observed. No sex-related differences were observed.