Abstract

Background

Intracranial meningiomas are the most common primary tumors of the central nervous system. How socioeconomic status (SES) impacts treatment access and outcomes for brain tumor subtypes is an emerging area of research. Few studies have examined the relationship between SES and meningioma survival and management with reference to relevant clinical factors, including age at diagnosis. We studied the independent effects of SES on receiving surgery and survival probability in patients with intracranial meningioma

Methods

54,282 patients diagnosed with intracranial meningioma between 2003 and 2012 from the Surveillance, Epidemiology, and End Results (SEER) Program at the National Cancer Institute database were included. Patient SES was divided into tertiles. Patient age groups included ‘older’ (>65, the median patient age) and ‘younger’. Multivariable linear regression and Cox proportional hazards model were used with SAS v9.4. Results were adjusted for race, sex, and tumor grade. Kaplan–Meier survival curves were constructed according to SES tertiles and age groups.

Results

Meningioma prevalence increased with higher SES tertile. Higher SES tertile was also associated with younger age at diagnosis (OR = 0.890, p < 0.05), an increased likelihood of undergoing gross total resection (GTR) (OR = 1.112, p < 0.05), and a trend toward greater 5-year survival probability (HR = 1.773, p = 0.0531). Survival probability correlated with younger age at diagnosis (HR = 2.597, p < 0.001), but not with GTR receipt.

Conclusion

The findings from this national longitudinal study on patients with meningioma suggest that SES affects age at diagnosis and treatment access for intracranial meningiomas patients. Further studies are required to understand and address the mechanisms underlying these disparities.

中文翻译：

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社会经济地位对颅内脑膜瘤患者诊断年龄和总生存期的影响

摘要

背景

颅内脑膜瘤是中枢神经系统最常见的原发性肿瘤。社会经济地位 (SES) 如何影响脑肿瘤亚型的治疗途径和结果是一个新兴的研究领域。很少有研究参考相关临床因素（包括诊断时的年龄）检查 SES 与脑膜瘤生存和管理之间的关系。我们研究了 SES 对颅内脑膜瘤患者接受手术和生存概率的独立影响

方法

纳入国家癌症研究所数据库的监测、流行病学和最终结果 (SEER) 项目的 2003 年至 2012 年期间诊断为颅内脑膜瘤的 54,282 名患者。患者 SES 被分成三等份。患者年龄组包括“年龄较大”（>65，患者年龄中位数）和“年轻”。多变量线性回归和 Cox 比例风险模型与 SAS v9.4 一起使用。结果根据种族、性别和肿瘤分级进行了调整。根据 SES 三分位数和年龄组构建 Kaplan-Meier 生存曲线。

结果

Meningioma prevalence increased with higher SES tertile. Higher SES tertile was also associated with younger age at diagnosis (OR = 0.890, p < 0.05), an increased likelihood of undergoing gross total resection (GTR) (OR = 1.112, p < 0.05), and a trend toward greater 5-year survival probability (HR = 1.773, p = 0.0531). Survival probability correlated with younger age at diagnosis (HR = 2.597, p < 0.001), but not with GTR receipt.

Conclusion

The findings from this national longitudinal study on patients with meningioma suggest that SES affects age at diagnosis and treatment access for intracranial meningiomas patients. Further studies are required to understand and address the mechanisms underlying these disparities.