Abstract

Background

Though meningioma is the most common primary brain tumor, there is a paucity of epidemiologic studies investigating disparities in treatment and patient outcomes. Therefore, we sought to explore how sociodemographic factors are associated with rates of gross total resection (GTR) and radiotherapy as well as survival.

Methods

The National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database was queried to identify adult patients with meningioma diagnosed between 2005 and 2015. Socioeconomic status (SES) was determined using a validated composite index in which patients were stratified into tertiles and quintiles. Multivariable logistic regression and Cox proportional hazards analyses were used to identify predictors of treatment and survival, respectively.

Results

71,098 patients met our inclusion criteria. Low SES quintile was associated with reduced odds of receiving GTR (OR 0.76, 95% CI 0.69–0.83, p < 0.0001) and radiotherapy (OR 0.83, 95% CI 0.76–0.91, p < 0.0001) as well as worse survival (HR 1.48, 95% CI 1.41–1.56) as compared to the highest SES quintile. Black patients had reduced odds of GTR (OR 0.74, 95% CI 0.67–0.71, p < 0.0001) and worse survival (HR 1.23, 95% CI 1.18–1.29, p < 0.0001) as compared to white patients.

Conclusions

This national study of patients with meningioma found socioeconomic status and race to be independent inverse correlates of likelihood of GTR, radiotherapy, and survival. Limited access to care may underlie these disparities in part, and future studies are warranted to identify specific causes for these findings.

中文翻译：

---

脑膜瘤患者治疗和生存的种族和社会经济相关性：一项基于人群的研究。

摘要

背景

尽管脑膜瘤是最常见的原发性脑肿瘤，但缺乏流行病学研究来调查治疗方法和患者预后之间的差异。因此，我们试图探讨社会人口统计学因素与总全切除率，放疗和生存率之间的关系。

方法

查询国家癌症研究所的监视，流行病学和最终结果（SEER）数据库，以鉴定在2005年至2015年之间诊断为脑膜瘤的成年患者。使用经过验证的综合指数确定社会经济地位（SES），其中将患者分为三分位数和五分位数。多变量logistic回归和Cox比例风险分析分别用于确定治疗和生存的预测指标。

结果

71,098例患者符合我们的纳入标准。低SES的五分位数与接受GTR（OR 0.76，95％CI 0.69-0.83，p <0.0001）和放疗（OR 0.83，95％CI 0.76-0.91，p <0.0001）的几率降低以及生存率降低（HR 1.48，95％CI（1.41-1.56），而最高的SES则为五分位数。与白人患者相比，黑人患者的GTR机率降低（OR 0.74，95％CI 0.67-0.71，p <0.0001），生存期更差（HR 1.23，95％CI 1.18-1.29，p <0.0001）。

结论

这项对脑膜瘤患者的全国性研究发现，社会经济地位和种族与GTR，放疗和生存的可能性之间呈独立的负相关。有限的就医机会可能是造成这些差异的部分原因，因此有必要进行进一步的研究以找出导致这些发现的具体原因。