# Incidence and Survival of IDH-Wildtype Glioblastoma and IDH-Mutant Astrocytoma by Treatment and Sex: A Regional Study in Spain (2011–2021)

## TL;DR

This study examines the incidence and survival rates of two brain tumor types in Spain, finding that IDH-mutant astrocytoma has better outcomes than IDH-wildtype glioblastoma.

## Contribution

The study provides real-world epidemiological and survival data for brain tumors in Southern Europe, highlighting sex and treatment effects.

## Key findings

- IDH-wildtype glioblastoma and IDH-mutant astrocytoma incidence increased significantly from 2011 to 2021.
- IDH-mutant astrocytoma had a median survival of 38.4 months, much higher than 12.3 months for IDH-wildtype glioblastoma.
- Multimodal therapy improved survival and progression-free survival for both tumor types, with male sex associated with better outcomes.

## Abstract

Background: The incidence and prognosis of high-grade gliomas differ according to histopathological and molecular features. The WHO 2021 CNS classification emphasized IDH status, but historical cohorts often lacked systematic molecular profiling. Methods: We conducted a retrospective population-based study including adult patients diagnosed with IDH-wildtype glioblastoma or IDH-mutant astrocytoma in a Spanish tertiary center (2011–2021). Incidence trends and survival outcomes were analyzed according to treatment modality and sex. Results: A total of 1057 patients were included: 530 (50.1%) with IDH-wildtype glioblastoma and 137 (13%) with IDH-mutant astrocytoma. Incidence of both subtypes significantly increased during the study period (p < 0.01). Median overall survival (OS) was 12.3 months for IDH-wildtype glioblastoma and 38.4 months for IDH-mutant astrocytoma. Multimodal therapy (surgery, radiotherapy, chemotherapy) significantly improved OS and progression-free survival (PFS) in both subgroups (p < 0.001). Male sex was associated with longer OS in both tumor types (p < 0.05). Conclusions: IDH-wildtype glioblastoma shows persistently poor outcomes despite increasing incidence, while IDH-mutant astrocytoma demonstrates better survival, particularly in male patients and those receiving multimodal therapy. These findings reflect real-world practice and provide epidemiological and survival data from Southern Europe to guide future clinical and public health strategies.