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

Catherine R. Garcia, Stacey A. Slone, Therese A. Dolecek, Bin Huang, Janna H. Neltner, John L. Villano

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

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.

Original languageEnglish
Pages (from-to)179-191
Number of pages13
JournalJournal of Neuro-Oncology
Volume144
Issue number1
DOIs
StatePublished - Aug 15 2019

Bibliographical note

Funding Information:
Funding Supported by the Biostatistics and Bioinformatics Shared Resource of the University of Kentucky Markey Cancer Center (P30CA177558).

Funding Information:
NCDB is a hospital-based dataset comprising data from over 1500 hospital cancer centers. It is supported by the American College of Surgeons Commission on Cancer (CoC) and the American Cancer Society, under well-established quality standards on collection methods [10, 11]. This database provides a unique opportunity to assess patterns of care with high-quality treatment information and survival estimates in a hospital-based setting, providing valuable information for primary CNS tumors [12]. A list of the CoC centers in the United States is available on the American College of Surgeons website (https://www.facs.org/search/cancer-progr ams) [13].

Publisher Copyright:
© 2019, Springer Science+Business Media, LLC, part of Springer Nature.

Keywords

  • Outcomes
  • Primary CNS tumors
  • Survival
  • Treatment

ASJC Scopus subject areas

  • Oncology
  • Neurology
  • Clinical Neurology
  • Cancer Research

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