High-grade gliomas (HGGs; WHO grade III or IV) are the most common and lethal brain malignancy. Patients of Hispanic ethnicity are diagnosed with HGGs earlier than non-Hispanic patients, but they exhibit improved HGG survival following diagnosis. Either environmental or biological factors could explain this survival benefit. We aimed to determine if post-diagnosis advantages would still be present in Hispanic patients with high social vulnerability, an environmental condition predisposing patients to poor oncologic outcomes. HGG outcomes were retrospectively assessed in a cohort of 22 Hispanic patients and 33 non-Hispanic patients treated for HGGs from 2015 to 2020 at a single institution that serves a highly vulnerable region. Compared to non-Hispanic patients, Hispanic patients demonstrated higher social vulnerability index scores (96.8 + 0.7 vs. 76.3 + 4.6; ***p= 0.0002) and a 14-month longer interval between diagnosis and recurrence (19.7 + 5.9 (n = 13) vs. 5.5 + 0.6 months (n = 19); **p= 0.001). In only those patients with more aggressive IDH-1 wildtype tumors (glioblastoma), Hispanic ethnicity still related to a longer time before recurrence (15.8 + 5.9 months (n = 9); 5.5 + 0.6 months (n = 18); *p= 0.034), and in a multivariate analysis, Hispanic ethnicity predicted time-to-recurrence (*p= 0.027) independent of patient age, functional status, MGMT gene methylation, or treatments received. Therefore, environmental factors, specifically social vulnerability, did not obscure the post-diagnosis benefits associated with Hispanic ethnicity. In future experiments, basic studies should be prioritized which investigate the cellular or genetic mechanisms underlying this ethnicity effect on HGG progression in the hopes of improving care for these devastating malignancies.
高级别胶质瘤（WHO III级或IV级）是最常见且致死率最高的脑部恶性肿瘤。西班牙裔患者比非西班牙裔患者更早被诊断为高级别胶质瘤，但确诊后却表现出更长的生存期。环境因素或生物学因素均可解释这种生存优势。本研究旨在探讨在具有高度社会脆弱性（一种易导致不良肿瘤预后的环境条件）的西班牙裔患者中，这种确诊后的生存优势是否仍然存在。我们回顾性分析了2015年至2020年间在服务于高脆弱性区域的单一医疗机构接受治疗的22名西班牙裔患者和33名非西班牙裔患者的高级别胶质瘤预后情况。与非西班牙裔患者相比，西班牙裔患者的社会脆弱性指数评分更高（96.8±0.7 vs. 76.3±4.6；***p=0.0002），且从确诊到复发的时间间隔延长14个月（19.7±5.9个月（n=13）vs. 5.5±0.6个月（n=19）；**p=0.001）。在仅考虑更具侵袭性的IDH-1野生型肿瘤（胶质母细胞瘤）患者时，西班牙裔仍与更长的复发前时间相关（15.8±5.9个月（n=9）；5.5±0.6个月（n=18）；*p=0.034）。多变量分析显示，西班牙裔是预测复发时间的独立因素（*p=0.027），不受患者年龄、功能状态、MGMT基因甲基化或所接受治疗的影响。因此，环境因素（特别是社会脆弱性）并未掩盖西班牙裔族群确诊后的生存优势。未来研究中应优先开展基础实验，探索这种族群差异影响高级别胶质瘤进展的细胞或遗传机制，以期改善这类致命恶性肿瘤的治疗策略。
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