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. 2019 Jun:60:16-22.
doi: 10.1016/j.canep.2019.02.018. Epub 2019 Mar 14.

Initial management of meningiomas: Analysis of the National Cancer Database

Catherine R Garcia  1 , Stacey A Slone  1 , Monica Chau  2 , Janna H Neltner  3 , Thomas Pittman  4 , John L Villano  5
Affiliations

Initial management of meningiomas: Analysis of the National Cancer Database

Catherine R Garcia et al. Cancer Epidemiol. 2019 Jun.

Abstract

Background: Meningiomas are the most common central nervous system tumor. We describe current trends in treatment and survival using the largest cancer dataset in the United States.

Methods: We analyzed the National Cancer Database from 2004 to 2014, for all patients with diagnosis of meningioma.

Results: 201,765 cases were analyzed. Patients were most commonly White (81.9%) females (73.2%) with a median age of 64 years. Fifty percent of patients were diagnosed by imaging. Patients were reported as grade I (24.9%), grade II (5.0%), grade III (0.7%), or unknown WHO grade (69.4%). Patients diagnosed by imaging were older, received treatment in community facilities, had higher Charlson-Deyo score, and a lower rate of private insurance. Watchful waiting was the most common treatment modality (46.7%), followed by surgery only (40%). Grade II and III patients were more likely to receive therapy. Watchful waiting increased from 35.2% in 2004 to 51.4% in 2014. Younger age, male gender, private insurance, and treatment in academic facilities were determinants for receipt of surgery and/or radiation. Median survival was 12.6 years, higher in histologically confirmed cases (13.1 years). Older patients, Blacks, males, those that received radiation plus surgery, and were treated in community facilities had an increased risk of mortality.

Conclusions: Over half of patients were diagnosed by imaging, suggesting a higher role of clinical determinants over histological confirmation in treatment decisions. Watchful waiting as initial management is increasing. Our survival analysis favored histological confirmation. Patients receiving radiation and surgery had an increased risk of mortality.

Keywords: Meningiomas; National Cancer Database; Outcomes; Survival; Treatment.

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Conflict of interest statement

Declarations: The authors have no conflicts of interest.

Figures

Figure 1.
Figure 1.
Summary of treatment receipt overall and by WHO grade
Figure 2.
Figure 2.
Survival by WHO grade (p<0.001)
Figure 3.
Figure 3.
Survival by type of diagnostic confirmation (p<0.001)
See this image and copyright information in PMC

References

    1. Ostrom QT, Gittleman H, Xu J, Kromer C, Wolinsky Y, Kruchko C, Barnholtz-Sloan JS, CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2009–2013, Neuro-oncology 18(suppl_5) (2016) v1–v75. - PMC - PubMed
    1. Campbell BA, Jhamb A, Maguire JA, Toyota B, Ma R, Meningiomas in 2009: controversies and future challenges, American journal of clinical oncology 32(1) (2009) 73–85. - PubMed
    1. Cavenee WK, Louis DN, Ohgaki H, Wiestler OD, International Agency for Research on Cancer., WHO classification of tumours of the central nervous system, Revised 4th edition. ed., International Agency For Research On Cancer, Lyon, 2016.
    1. Zhang H, Rodiger LA, Shen T, Miao J, Oudkerk M, Preoperative subtyping of meningiomas by perfusion MR imaging, Neuroradiology 50(10) (2008) 835–40. - PubMed
    1. Vernooij MW, Ikram MA, Tanghe HL, Vincent AJPE, Hofman A, Krestin GP, Niessen WJ, Breteler MMB, van der Lugt A, Incidental Findings on Brain MRI in the General Population, New England Journal of Medicine 357(18) (2007) 1821–1828. - PubMed

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