Sunil W Dutta1, Jennifer L Peterson2, Laura A Vallow3, Anita Mahajan4, Steven S Rosenfeld5, Alfredo Quiñones-Hinojosa6, Daniel M Trifiletti2. 1. Department of Radiation Oncology, University of Virginia, Charlottesville, VA, USA. Electronic address: nwdutta@gmail.com. 2. Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL, USA; Department of Neurological Surgery, Mayo Clinic, Jacksonville, FL, USA. 3. Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL, USA. 4. Department of Radiation Oncology, Mayo Clinic, Rochester, MN, USA. 5. Department of Neurology, Mayo Clinic, Jacksonville, FL, USA. 6. Department of Neurological Surgery, Mayo Clinic, Jacksonville, FL, USA.
Abstract
PURPOSE: To analyze the national treatment trends of patients diagnosed with benign intracranial meningioma. METHODS AND MATERIALS: Data was obtained from the National Cancer Database (NCDB) for patients with WHO grade I meningioma tumors between 2004 and 2014 (190,527 patients), diagnosed by either surgical specimen or diagnostic imaging. Univariable and multivariable analyses (binary logistic models) were performed to generate odds ratios (OR) and investigate factors associated with definitive initial treatment compared to initial observation. Initial treatments considered included surgical resection and/or radiation, including either fractionated external beam radiotherapy (EBRT) or stereotactic radiosurgery (SRS). RESULTS: The rate of observation increased over time, from 37% in 2004 to 55% in 2014 (p < 0.001). Conjointly, the rate of resection decreased from 50% to 37% from 2004 to 2014 (p < 0.001). The utilization of radiotherapy, including SRS, remained generally stable over time at 6% or less. SRS was more frequently utilized, compared to EBRT, as definitive treatment (4.6% versus 1.7%, respectively, p < 0.001). Compared to Community Cancer programs, patients at Academic/Research programs were more likely to receive definitive initial treatment over observation (OR = 2.909, each p < 0.001). CONCLUSIONS: There is a national trend favoring initial observation for radiographically diagnosed WHO grade I meningioma. However, patients presenting to academic facilities are more likely to receive definitive initial treatment. Further research into differing approaches among treatment facilities for this common tumor may help clarify this trend.
PURPOSE: To analyze the national treatment trends of patients diagnosed with benign intracranial meningioma. METHODS AND MATERIALS: Data was obtained from the National Cancer Database (NCDB) for patients with WHO grade I meningioma tumors between 2004 and 2014 (190,527 patients), diagnosed by either surgical specimen or diagnostic imaging. Univariable and multivariable analyses (binary logistic models) were performed to generate odds ratios (OR) and investigate factors associated with definitive initial treatment compared to initial observation. Initial treatments considered included surgical resection and/or radiation, including either fractionated external beam radiotherapy (EBRT) or stereotactic radiosurgery (SRS). RESULTS: The rate of observation increased over time, from 37% in 2004 to 55% in 2014 (p < 0.001). Conjointly, the rate of resection decreased from 50% to 37% from 2004 to 2014 (p < 0.001). The utilization of radiotherapy, including SRS, remained generally stable over time at 6% or less. SRS was more frequently utilized, compared to EBRT, as definitive treatment (4.6% versus 1.7%, respectively, p < 0.001). Compared to Community Cancer programs, patients at Academic/Research programs were more likely to receive definitive initial treatment over observation (OR = 2.909, each p < 0.001). CONCLUSIONS: There is a national trend favoring initial observation for radiographically diagnosed WHO grade I meningioma. However, patients presenting to academic facilities are more likely to receive definitive initial treatment. Further research into differing approaches among treatment facilities for this common tumor may help clarify this trend.
Authors: Catherine R Garcia; Stacey A Slone; Monica Chau; Janna H Neltner; Thomas Pittman; John L Villano Journal: Cancer Epidemiol Date: 2019-03-14 Impact factor: 2.984
Authors: Andrew I Yang; Kobina G Mensah-Brown; Cole Rinehart; Ramie Fathy; Frederick L Hitti; Jason Brant; John Y K Lee Journal: Cureus Date: 2020-03-18