Recent COVID-19 Vaccination Before Glioblastoma Surgery Is Associated With Longer Survival
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Background
Glioblastoma remains resistant to most immune-based therapies. Surgery may create a perioperative window in which systemic immune activation and tumor antigen release intersect. We evaluated whether COVID-19 vaccination shortly before first glioblastoma surgery was associated with survival.
Methods
We performed a retrospective single-center cohort study of adults with newly diagnosed glioblastoma undergoing initial biopsy or resection from 2021 to 2025. The primary exposure was documented COVID-19 vaccination within 100 days before first tumor surgery. Overall survival was analyzed from surgery using Kaplan–Meier and Cox models, with 1:1 propensity matching and sensitivity analyses addressing treatment completion, calendar time, surgical selection, steroid exposure, immune-cell variables, COVID severity, and negative-control vaccination.
Results
The cohort included 187 patients: 64 perioperatively vaccinated and 123 non-perioperative comparators. Among vaccinated patients, 59/64 (92.2%) received mRNA vaccines; median vaccination-to-surgery interval was 81 days (IQR 71–90). Median overall survival was 743 days in vaccinated patients versus 318 days in comparators (unmatched HR 0.48, 95% CI 0.30–0.76; p=0.002). After 1:1 matching, median survival was 743 versus 349 days (HR 0.52, 95% CI 0.34–0.80). Sensitivity analyses accounting for adjuvant therapy, surgery year, extent of resection, steroid exposure, immune-cell measures, and COVID hospitalization were directionally consistent. Influenza vaccination was not associated with survival.
Conclusions
COVID-19 vaccination within 100 days before first glioblastoma surgery was associated with longer overall survival. These findings identify perioperative vaccination timing as a potentially relevant and modifiable variable in glioblastoma outcomes.
