High-grade gliomas, especially glioblastoma, are associated with poor prognosis. We investigated the prognostic impact of first visiting a neurosurgery department or other departments among patients with high-grade gliomas in real-world clinical practice in Japan. We analyzed health insurance claims data from the Japan Medical Data Centre Claims Database for 540 patients with records of C71 (malignant neoplasm of the brain), surgery, radiotherapy, and temozolomide, indicative of high-grade gliomas. The median age was 54 years, 70.9% of the patients were aged <60 years, and 63.0% of the patients were male. Among 375 evaluable patients who first visited a hospital different to the one where the surgery was performed, the most common department visited was general internal medicine (43.0%); 13.0% visited a neurosurgical department. The median interval from the initial visit to surgery was 35.0 days and 19.0 days for patients who first visited a general internal medicine and a neurosurgery department, respectively. The proportions of patients who underwent surgery within 21 days of the initial visit to a general internal medicine and a neurosurgery department were 37.5% and 62.2%, respectively. The 3-year overall survival rates were numerically greater in patients who first visited a neurosurgery department (72.7%) than in patients who first visited other departments (57.7%), but not significantly (log-rank p = 0.39). Our results suggest that the treatment of high-grade gliomas was delayed if patients first visited non-neurosurgery departments, leading to poor outcomes. Our findings suggest that early neurosurgery consultation and surgery may improve the outcomes of patients with high-grade gliomas.
Fukui et al. (Thu,) studied this question.