To retrospectively assess medical comorbidities as determinants of survival in glioblastoma patients. 

Glioblastoma accounts for over half of primary malignant brain tumors in adults. Five-year survival is <10%. Age, neurologic performance, extent of resection, and certain molecular markers are known to influence patient survival. The impact of medical comorbidities requires further investigation. 

All patients with glioblastoma treated at Rhode Island Hospital between 2005 and 2021 were identified from the Lifespan Cancer Center database. Demographic information was extracted together with pathology and tumor-related molecular data. Comorbidities at diagnosis, including hypertension, hyperlipemia, and diabetes were tabulated. Additionally, clinical information on resolved or concurrent malignancies was documented. Comparisons between groups were conducted using Kaplan-Meier survival statistics and Kruskal-Wallis testing with correction for multiple comparisons. 

The analysis included 868 glioblastoma patients (56.5% male, 43.2% female). Comorbidity incidence rates were 57.5% for hypertension, 47.9% for hyperlipidemia, 15.8% for type 2 diabetes mellitus (T2DM), and 16.5% for other malignancies. Hypertensive patients had a lower median overall survival (mOS) compared to non-hypertensive patients, 9 (95% CI 8–11) vs. 14 (95% CI 12–16) months, respectively (p<0.001). Decreased mOS was noted in patients with hyperlipidemia compared to those without, 9 (95% CI 8–11) vs. 13 (95% CI 11–14) months, respectively (p<0.001). Patients with T2DM had a shortened mOS compared to non-diabetic patients, 7 (95% CI 6–10) vs. 12 (95% CI 11–13) months, respectively (p<0.001). Those with past or contemporaneous cancer history had a mOS of 9 (95% CI 7–11) months, compared to 12 (95% CI 11–13) months in those without (p=0.01).

Hypertension, hyperlipidemia, T2DM, and additional malignancies significantly correlate with decreased survival of glioblastoma patients. Therapeutic trials for these patients should account for the influence of medical comorbidities on treatment efficacy.