BACKGROUND: To investigate the effects of SES and geographic variations on survival for adult patients with glioma, we analyzed data from 30489 patients from the Cancer Registry in England and Wales. METHODS: Median survival and CSRs for 8 variables (age, sex, morphology, World Health Organization [WHO] grade, tumor site, SES, geographic regions, and periods of diagnosis) are calculated using the Kaplan-Meier method. Distributions among different variables are compared using chi(2) test. Cox regressions are performed for estimating HRs to death. RESULTS: The median survival and the 1-, 5-, and 10-year CSR in this population are 0.42 years, 29.1%, 12.0%, and 7.7%, respectively. There is a gradient in SES from the south to the north (chi(2) test, P < .001) and a gradual increment in higher SES from the early to the recent period (chi(2) test, P < .001). Mono- and multivariate analyses reveal that all the 8 variables influenced the survival (P < .05). Age (HR, 1.04 per year from 15 years, P < .001), WHO grade (1.21 per grade from grade I, P < .001), and morphology (HR from 1.23 to 1.89, compared with ependymoma, P < .05) are the most influential factors. However, there are also independent effects from SES (HR, 1.03 per quintile of deprivation, P < .001) and geographic regions (HR, 1.10 for outside southern England; P < .001) on the survival. CONCLUSIONS: Although age and tumor characteristics (morphology, WHO grade, tumor site) are well-known prognostic factors, SES and geographic variations also play a slight but significant role, and for more cost-effective allocation of health resources, alleviation on these 2 modifiable factors should be considered.
BACKGROUND: To investigate the effects of SES and geographic variations on survival for adult patients with glioma, we analyzed data from 30489 patients from the Cancer Registry in England and Wales. METHODS: Median survival and CSRs for 8 variables (age, sex, morphology, World Health Organization [WHO] grade, tumor site, SES, geographic regions, and periods of diagnosis) are calculated using the Kaplan-Meier method. Distributions among different variables are compared using chi(2) test. Cox regressions are performed for estimating HRs to death. RESULTS: The median survival and the 1-, 5-, and 10-year CSR in this population are 0.42 years, 29.1%, 12.0%, and 7.7%, respectively. There is a gradient in SES from the south to the north (chi(2) test, P < .001) and a gradual increment in higher SES from the early to the recent period (chi(2) test, P < .001). Mono- and multivariate analyses reveal that all the 8 variables influenced the survival (P < .05). Age (HR, 1.04 per year from 15 years, P < .001), WHO grade (1.21 per grade from grade I, P < .001), and morphology (HR from 1.23 to 1.89, compared with ependymoma, P < .05) are the most influential factors. However, there are also independent effects from SES (HR, 1.03 per quintile of deprivation, P < .001) and geographic regions (HR, 1.10 for outside southern England; P < .001) on the survival. CONCLUSIONS: Although age and tumor characteristics (morphology, WHO grade, tumor site) are well-known prognostic factors, SES and geographic variations also play a slight but significant role, and for more cost-effective allocation of health resources, alleviation on these 2 modifiable factors should be considered.
Authors: Adelheid Wöhrer; Thomas Waldhör; Harald Heinzl; Monika Hackl; Johann Feichtinger; Ulrike Gruber-Mösenbacher; Andreas Kiefer; Hans Maier; Reinhard Motz; Angelika Reiner-Concin; Bernd Richling; Carmen Idriceanu; Michael Scarpatetti; Roland Sedivy; Hans-Christian Bankl; Wolfgang Stiglbauer; Matthias Preusser; Karl Rössler; Johannes Andreas Hainfellner Journal: J Neurooncol Date: 2009-06-28 Impact factor: 4.130
Authors: S C Erridge; M G Hart; G R Kerr; C Smith; S McNamara; R Grant; A Gregor; I R Whittle Journal: J Neurooncol Date: 2011-03-08 Impact factor: 4.130
Authors: Desmond A Brown; Benjamin T Himes; Panagiotis Kerezoudis; Yirengah M Chilinda-Salter; Sanjeet S Grewal; Joshua A Spear; Mohamad Bydon; Terry C Burns; Ian F Parney Journal: Neuro Oncol Date: 2018-09-03 Impact factor: 12.300
Authors: Theodore Wang; Anthony Pham; Stella Yoo; Frank J Attenello; Richard Jennelle; Naveed Wagle; Eric L Chang; Gabriel Zada Journal: World Neurosurg Date: 2020-01-27 Impact factor: 2.104