___Figure 6___
Our study has several limitations. The database is restricted to GBM patients in Guilan Province, impacting the generalizability of findings. The low tumor incidence led to limited patient data for several hospitals, underscoring the need for a larger sample size per center to address within-hospital variation. Moreover, the study lacks details regarding the specific types of treatment administered, including the particular chemotherapeutic agents used for each patient. It is possible that these treatment details could have an impact on sex differences in outcomes and survival rates. Further studies utilizing different databases are needed to investigate factors unavailable in our research, such as IDH mutation status, to provide a more comprehensive understanding of sex-based differences in survival and outcomes for gliomas.