Skip to main content
SpringerLink
Log in

Racial and socioeconomic correlates of treatment and survival among patients with meningioma: a population-based study

  • Clinical Study
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Ostrom QT, Gittleman H, Xu J et al (2016) CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2009–2013. Neuro Oncol 18(suppl_5):v1–v75

    Article  Google Scholar 

  2. Buerki RA, Horbinski CM, Kruser T, Horowitz PM, James CD, Lukas RV (2018) An overview of meningiomas. Fut Oncol (London, England) 14(21):2161–2177

    Article  CAS  Google Scholar 

  3. Bi WL, Dunn IF (2017) Current and emerging principles in surgery for meningioma. Chin Clin Oncol 6(Suppl 1):S7

    Article  Google Scholar 

  4. Kalamarides M, Stemmer-Rachamimov AO, Niwa-Kawakita M et al (2011) Identification of a progenitor cell of origin capable of generating diverse meningioma histological subtypes. Oncogene 30(20):2333–2344

    Article  CAS  Google Scholar 

  5. Apra C, Peyre M, Kalamarides M (2018) Current treatment options for meningioma. Expert Rev Neurother 18(3):241–249

    Article  CAS  Google Scholar 

  6. Goldbrunner R, Minniti G, Preusser M et al (2016) EANO guidelines for the diagnosis and treatment of meningiomas. Lancet Oncol 17(9):e383–391

    Article  Google Scholar 

  7. Hwang KL, Hwang WL, Bussiere MR, Shih HA (2017) The role of radiotherapy in the management of high-grade meningiomas. Chin Clin Oncol 6(Suppl 1):S5

    Article  Google Scholar 

  8. Pinzi V, Biagioli E, Roberto A et al (2017) Radiosurgery for intracranial meningiomas: a systematic review and meta-analysis. Crit Rev Oncol/Hematol 113:122–134

    Article  Google Scholar 

  9. Rogers L, Barani I, Chamberlain M et al (2015) Meningiomas: knowledge base, treatment outcomes, and uncertainties. A RANO review. J Neurosurg 122(1):4–23

    Article  Google Scholar 

  10. Sun SQ, Hawasli AH, Huang J, Chicoine MR, Kim AH (2015) An evidence-based treatment algorithm for the management of WHO Grade II and III meningiomas. Neurosurg Focus 38(3):E3

    Article  Google Scholar 

  11. Curry WT Jr, Barker FG 2nd (2009) Racial, ethnic and socioeconomic disparities in the treatment of brain tumors. J Neurooncol 93(1):25–39

    Article  Google Scholar 

  12. Surveillance Epidemiology and End Results program (www.seer.cancer.gov). Database: Census Tract-level SES and Rurality Database (2000–2015)

  13. Yost K, Perkins C, Cohen R, Morris C, Wright W (2001) Socioeconomic status and breast cancer incidence in California for different race/ethnic groups. Cancer Causes Control 12:703–711

    Article  CAS  Google Scholar 

  14. Ostrom QT, Gittleman H, Liao P et al (2017) CBTRUS statistical report: Primary brain and other central nervous system tumors diagnosed in the United States in 2010–2014. Neuro Oncol 19(suppl_5):v1–v88

    Article  Google Scholar 

  15. Cahill KS, Claus EB (2011) Treatment and survival of patients with nonmalignant intracranial meningioma: results from the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute Clinical article. J Neurosurg 115(2):259–267

    Article  Google Scholar 

  16. Mukherjee D, Patil CG, Todnem N et al (2013) Racial disparities in Medicaid patients after brain tumor surgery. J Clin Neurosci 20(1):57–61

    Article  Google Scholar 

  17. Wong J, Mendelsohn D, Nyhof-young J, Bernstein M (2011) A qualitative assessment of the supportive care and resource needs of patients undergoing craniotomy for benign brain tumours. Support Care Cancer 19(11):1841–1848

    Article  Google Scholar 

  18. Baba A, McCradden MD, Rabski J, Cusimano MD (2019) Determining the unmet needs of patients with intracranial meningioma—a qualitative assessment. Neuro-Oncol Pract. https://doi.org/10.1093/nop/npz054

    Article  Google Scholar 

  19. Rinehart CD, Yang AI, Fathy R, Hitti FL, Brant J et al (2019) Inequalities in meningioma survival: results from the National Cancer Database. Neurooncol Open Access 4(1):2

    Google Scholar 

  20. Rogers A, Flowers J, Pencheon D (1999) Improving access needs a whole systems approach. BMJ 319:866–867

    Article  CAS  Google Scholar 

  21. Basu J, Clancy C (2001) Racial disparity, primary care, and specialty referral. Health Serv Res 36(6 Pt 2):64–77

    CAS  PubMed  PubMed Central  Google Scholar 

  22. Bach PB, Pham HH, Schrag D et al (2004) Primary care physicians who treat blacks and whites. N Engl J Med 351:575–584

    Article  CAS  Google Scholar 

  23. Greenberg CC, Weeks JC, Stain SC (2008) Disparities in oncologic surgery. World J Surg 32(4):522–528

    Article  Google Scholar 

  24. Tammemagi CM, Nerenz D, Neslund-Dudas C et al (2005) Comorbidity and survival disparities among black and white patients with breast cancer. JAMA 294:1765–1772

    Article  CAS  Google Scholar 

  25. Dein S (2004) Explanatory models of and attitudes towards cancer in different cultures. Lancet Oncol 5:119–124

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Stanford University, Stanford, CA, USA

    Hriday P. Bhambhvani, Adrian J. Rodrigues, Zachary A. Medress & Melanie Hayden Gephart

Authors
  1. Hriday P. Bhambhvani
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Adrian J. Rodrigues
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Zachary A. Medress
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Melanie Hayden Gephart
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Melanie Hayden Gephart.

Ethics declarations

Conflict of interest

The authors have no conflicts of interest to report. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary file1 (PDF 45 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bhambhvani, H.P., Rodrigues, A.J., Medress, Z.A. et al. Racial and socioeconomic correlates of treatment and survival among patients with meningioma: a population-based study. J Neurooncol 147, 495–501 (2020). https://doi.org/10.1007/s11060-020-03455-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11060-020-03455-2

Keywords

Search

Navigation