Yang Andrew I, Mensah-Brown Kobina G, Rinehart Cole, Fathy Ramie, Hitti Frederick L, Brant Jason, Lee John Y K
Neurosurgery, University of Pennsylvania, Philadelphia, USA.
Neurological Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.
Cureus. 2020 Mar 18;12(3):e7304. doi: 10.7759/cureus.7304.
Background Meningiomas are the second most common primary tumors of the central nervous system. However, there is a paucity of literature examining how healthcare, demographic, and socioeconomic factors impact patient outcomes. Methods We conducted a retrospective study of 65,812 patients from the National Cancer Database (NCDB; 2004-2012) who received treatment for their meningioma. Univariate and multivariate analyses were performed with the overall five-year survival as the primary outcome, and the following factors: facility type, geography, housing area, patient insurance, sex, ethnicity, race, income, and education. The multivariate model was adjusted for patient age, co-morbidity, tumor size, behavior, and treatment strategy. Results Diagnosis and treatment at an academic/research program, private insurance, female sex, Hispanic ethnicity, and high school diploma conferred a survival advantage on both univariate and multivariate analyses. Conclusions Disparities in survival outcomes in patients with meningiomas exist across multiple healthcare, demographic, and socioeconomic factors. Additional research is needed to elucidate the genetic and environmental factors driving these inequalities.
脑膜瘤是中枢神经系统第二常见的原发性肿瘤。然而，关于医疗保健、人口统计学和社会经济因素如何影响患者预后的文献较少。方法：我们对国家癌症数据库（NCDB；2004 - 2012年）中65812例接受脑膜瘤治疗的患者进行了回顾性研究。以总体五年生存率为主要结局，对以下因素进行单因素和多因素分析：医疗机构类型、地理位置、居住面积、患者保险、性别、种族、民族、收入和教育程度。多因素模型对患者年龄、合并症、肿瘤大小、行为和治疗策略进行了调整。结果：在单因素和多因素分析中，在学术/研究机构进行诊断和治疗、拥有私人保险、女性、西班牙裔种族以及高中文凭都具有生存优势。结论：脑膜瘤患者的生存结局在多个医疗保健、人口统计学和社会经济因素方面存在差异。需要进一步研究以阐明导致这些不平等现象的遗传和环境因素。
