Abstract
Background
High grade GBM is the most common intra-axial brain tumor in adults aged 20 years or above, with an incidence rate of 3 cases per hundred thousand. These tumors are histopathologically classified from grade 1 to 4, with grade 3 and 4 highly malignant. GBMs are invasive, rarely metastasize outside central nervous system, but invade normal brain tissue. The WHO classifies GBM based on genetic types: IDH mutant and IDH wild type, with the latter being more aggressive.
Aim and objective
To identify the common locations of GBM in adult patients and its correlation on the survival rate of adult patients with GBM.
Material and methods
This is a descriptive case series study conducted at the department of neurosurgery, Khyber girl’s medical college, Hayatabad medical complex, Peshawar from January 2021 to January 2023. The study included 110 patients aged 20 years and above diagnosed with high grade GBM. All patients had radiological and histopathological evaluations, followed by surgery, radiotherapy and chemotherapy. Survival rates were analyzed based on tumor location.
Results
Among 110 patients, 57% were male and 43% female with mean age 55 ± 13.6. Peripheral tumors were present in 74% patient while 25.5% had central tumors. Survival of patients with peripheral tumors till 6 months was 87.8%, till 12 months was 43.9%. In central tumors survival till 6 months was 39.7%, till 12 months was 3.6%.
Discussion
This study highlights the critical impact of tumor location on GBM prognosis. Peripheral tumors especially have better survival rate due to accessibility for surgical resection and better response to therapy. In contrast central tumors have poor survival outcome due to their aggressive nature and challenging anatomical locations.
Conclusion
Tumor location and IDH mutation status significantly influences the prognosis of high grade GBM. Personalized treatment approaches, integrating advanced surgical techniques and innovative therapies, are essential to improve clinical outcomes for GBM patients.  
Key word   Glioblastoma multiforme, Karnofsky performance status