Department of Neurosurgery, Neurological Institute, Cleveland Clinic, Cleveland, Ohio.
Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, Ohio.
Neuro Oncol. 2019 Feb 19;21(3):380-391. doi: 10.1093/neuonc/noy162.
Meningioma incidence increases significantly with age. In the expanding elderly population, we lack complete understanding of population-based trends in meningioma incidence/survival. We provide an updated, comprehensive analysis of meningioma incidence and survival for individuals aged over 65.
Data were obtained from the Central Brain Tumor Registry of the United States (CBTRUS) from 2005-2015 for nonmalignant and malignant meningioma. Age-adjusted incidence rates per 100000 person-years were analyzed by age, sex, race, ethnicity, location, and treatment modalities. Survival was analyzed using Kaplan-Meier and multivariable Cox proportional hazards models for a subset of CBTRUS data.
Nonmalignant meningioma incidence doubled from adults age 65-69 years to adults over age 85 years and was significantly greater in females than males for all ages. Malignant meningioma incidence did not differ by sex for any age grouping. Nonmalignant and malignant meningioma incidence was significantly greater in black populations versus others. Nonmalignant meningioma survival was worse with age, in black populations, and in males, including when analyzed by 5-year age groups. Surgical resection and radiation did not improve survival compared with resection alone in nonmalignant meningioma.
This study reports increasing nonmalignant meningioma incidence in the elderly, increased incidence in black populations, and in females. In contrast, malignant meningioma incidence did not differ between sexes. Risk of death was higher for black individuals and males. Additionally, radiation did not confer a survival advantage when combined with resection for nonmalignant meningioma. Thus, we identify clinically relevant discrepancies in meningioma incidence/survival that require further study.
脑膜瘤的发病率随年龄增长显著增加。在不断扩大的老年人群中，我们对脑膜瘤发病率/生存率的基于人群的趋势缺乏全面了解。我们提供了一项针对 65 岁以上人群脑膜瘤发病率和生存率的最新、全面分析。
数据来自美国中央脑肿瘤登记处（CBTRUS），涵盖 2005 年至 2015 年的非恶性和恶性脑膜瘤病例。按年龄、性别、种族、族裔、部位和治疗方式分析每 100000 人年的年龄调整发病率。使用 Kaplan-Meier 和多变量 Cox 比例风险模型对 CBTRUS 数据的一部分进行生存分析。
非恶性脑膜瘤的发病率从 65-69 岁的成年人增加到 85 岁以上的成年人，增加了一倍，并且在所有年龄段女性的发病率都明显高于男性。在任何年龄段，恶性脑膜瘤的发病率都没有因性别而异。黑人群体的非恶性和恶性脑膜瘤发病率明显高于其他人群。非恶性脑膜瘤的生存率随年龄增长而降低，在黑人群体和男性中尤其如此，包括按 5 岁年龄组进行分析时。与单独手术切除相比，手术切除联合放疗并不能改善非恶性脑膜瘤的生存率。
本研究报告了老年人群中非恶性脑膜瘤发病率增加、黑人群体发病率增加、女性发病率增加。相比之下，恶性脑膜瘤的发病率在性别之间没有差异。黑人个体和男性的死亡风险更高。此外，对于非恶性脑膜瘤，放疗联合手术切除并不能带来生存优势。因此，我们发现脑膜瘤发病率/生存率存在临床相关差异，需要进一步研究。
