{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T01:04:27Z","timestamp":1780707867198,"version":"3.54.1"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T00:00:00Z","timestamp":1757548800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T00:00:00Z","timestamp":1757548800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100007465","name":"UiT The Arctic University of Norway","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100007465","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Neurooncol"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Purpose<\/jats:title>\n            <jats:p>Surveillance of patient outcomes with real-world data is essential to uncover regional disparities in clinical practice or quality of care. This study explored survival differences among glioblastoma patients in Norway and investigated the role of demographic and treatment factors.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We analyzed real-world data from the Norwegian Cancer Registry on 1158 adults with histologically confirmed glioblastoma during 2019\u20132023. Surgical treatment rates per 100,000 inhabitants per region (South-East, West, Mid, North) were compared using adjusted Poisson models. Full treatment included surgical resection, radiotherapy (\u2265\u200955\u00a0Gy for \u2264\u200970 years; \u226530\u00a0Gy for &gt;\u200970 years), and temozolomide. Standardized survival was estimated with flexible parametric models, standardized for age, sex, year, and distances to treatment facilities.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Patients from the North were older and lived further from treatment centers. For patients aged 18\u201370, treatment and survival did not significantly differ across regions; national median standardized survival was 14.4 months (95%CI:13.6\u201315.2). For elderly patients (71\u201389 years), the North demonstrated a higher surgical treatment rate (rate ratio\u2009=\u20091.32; 95%CI\u2009=\u20090.99\u20131.77), but lesser use of postoperative radiotherapy and temozolomide. Median standardized survival for elderly patients in the North was 4.5 months (95%CI: 3.5\u20135.7) versus 7.7 (6.9\u20138.6) months nationally. Early mortality was particularly high for elderly patients in the North, yet those surviving beyond six months matched other regions\u2019 survival probability.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Lower glioblastoma survival in the North was associated with higher early mortality among elderly patients, likely due to selecting frailer patients for surgery, who less often subsequently received anti-neoplastic treatment.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s11060-025-05218-3","type":"journal-article","created":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T06:38:58Z","timestamp":1757572738000},"page":"1355-1366","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Unveiling regional differences in glioblastoma patient survival with real-world data from the Norwegian brain tumor quality 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SS has received consulting fees for NX Development. TS has received support for travel for attending meetings with the advisory board for the Norwegian Brain and Spinal Cord Tumour Registry. EOVM has received research support from the Norwegian Cancer Society, the Research Council of Norway, the South-Eastern Norway Regional Health Authority and TRANSCAN. EOVM is an invited lecturer in a symposium organized by Oxford Nanopore Technologies. PB has received research support from the Norwegian Cancer Society and the South-Eastern Norway Regional Health Authority. PB has received consulting fees for Ekspertpanelet (national institution) and Moloklinikken. ES has received research support (paid to institution) from the Research Fund Foundation of Oslo University Hospital and the South-Eastern Norway Regional Health Authority.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Financial interests"}},{"value":"LO is the leader of the Global ECT-MRI Research collaboration (GEMRIC). SS is a board member of ALA-RDT in GBM, ALA SDT Glioma 401. PB is the leader of the Norwegian Neuro-Oncology Group and board leader of the Norwegian Oncological Forum. TI is the leader of the advisory board for the Norwegian Brain and Spinal Cord Tumour Registry. TI is an executive board member of the Norwegian Cancer Society and the Norwegian Neurosurgical Society.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Non-financial interests"}},{"value":"The analyses presented in this study are covered by the purview of the Cancer Registry of Norway\u2019s mandate and approval to provide delivery of tailored statistics.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent from the subjects was not required according to the Norwegian Health Register Act \u00a7\u00a019.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}