Racial and socioeconomic correlates of treatment and survival among patients with meningioma: a population-based study
Racial and socioeconomic correlates of treatment and survival among patients with meningioma: a population-based study
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DOI：
10.1007/s11060-020-03455-2
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发表时间：
2020-03-19
影响因子：
3.9
通讯作者：
Gephart, Melanie Hayden
中科院分区：
文献类型：
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作者：
Bhambhvani, Hriday P.;Rodrigues, Adrian J.;Gephart, Melanie Hayden
虽然脑膜瘤是最常见的原发性脑肿瘤，但很少有流行病学研究调查治疗和患者结局的差异。因此，我们试图探讨社会人口因素与大体全切除率（GTR）和放疗率以及生存率的关系。方法查询国家癌症研究所的监测，流行病学和最终结果（SEER）数据库，以确定2005年至2015年期间诊断为脑膜瘤的成年患者。社会经济地位（SES）确定使用一个有效的复合指数，其中患者分为三分之一和五分之一。多变量逻辑回归和考克斯比例风险分析分别用于确定治疗和生存的预测因素。结果71，098例患者符合我们的入选标准。与最高SES五分位数相比，低SES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）相关。与白色患者相比，黑人患者GTR的几率降低（OR 0.74，95% CI 0.67-0.71，p < 0.0001），生存率更差（HR 1.23，95% CI 1.18-1.29，p < 0.0001）。结论：这项全国性的脑膜瘤患者研究发现，社会经济地位和种族是GTR、放疗和生存率的独立负相关因素。有限的医疗服务可能是这些差异的部分原因，未来的研究有必要确定这些发现的具体原因。
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.