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. 2019 Aug;144(1):179-191.
doi: 10.1007/s11060-019-03218-8. Epub 2019 Jun 28.

Primary central nervous system tumor treatment and survival in the United States, 2004-2015

Catherine R Garcia  1 , Stacey A Slone  2 , Therese A Dolecek  3 , Bin Huang  4 , Janna H Neltner  5 , John L Villano  6   7
Affiliations

Primary central nervous system tumor treatment and survival in the United States, 2004-2015

Catherine R Garcia et al. J Neurooncol. 2019 Aug.

Abstract

Introduction: Brain tumor treatment and survival information is generally limited in large-scale cancer datasets. We provide a clinical investigation of current patterns of care and survival estimates for central nervous system (CNS) tumors treated in the United States.

Methods: We analyzed the National Cancer Database from 2004-2015 for all patients with diagnosis of primary CNS tumors. We describe patient demographics, treatment modality, and analyzed survival estimates.

Results: 512,168 patient tumor records were examined. The most common histology was meningioma (43.6%), followed by glioblastoma (22.0%), and nerve sheath tumors (10.6%). Patients had a median age of 60 years, with a female (57.9%), white (85.0%), and non-Hispanic (87.8%) predominance. Tumors were reported as World Health Organization (WHO) grade I for 55.9% of the patients, grade II for 5.9%, grade III for 4.4%, grade IV for 24.3%, and grade unknown or not applicable for 9.4%. Overall, 56% underwent surgical procedures, 30.4% received radiation, and 20.6% received chemotherapy. Radiation plus chemotherapy and surgery was the most common treatment modality in high-grade tumors (40.5% in WHO grade III and 49.3% in WHO grade IV), while surgery only or watchful waiting was preferred in low-grade tumors. Older age, male gender, non-Hispanic origin, higher number of comorbidities, and lower socioeconomic status were identified as risk factors for mortality.

Conclusions: Our analysis provides long-term survival estimates and initial treatment decisions for patients with CNS tumors in hospitals throughout the United States. Age, comorbidities, gender, ethnicity, and socioeconomic characteristics were determinants of survival.

Keywords: Outcomes; Primary CNS tumors; Survival; Treatment.

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Conflict of interest statement

Compliance with Ethical Standards:

Conflict of Interest: The authors declare no conflict of interest.

Declarations: The authors have no conflicts of interest.

Figures

Figure 1
Figure 1
A. Age group distribution B. Tumor location distribution, NCDB 2004–2015.
Figure 2.
Figure 2.
Histology groups distribution by WHO grade group, NCDB 2004–2015.
Figure 3.
Figure 3.
Multivariate analysis for risk factors for mortality for all patients with brain tumors, NCDB 2004–2014.
See this image and copyright information in PMC

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