15 results on '"Kruchko, Carol"'
Search Results
2. Brain tumors in United States military veterans.
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Bihn JR, Cioffi G, Waite KA, Kruchko C, Neff C, Price M, Ostrom QT, Swinnerton KN, Elbers DC, Mooney MA, Rachlin J, Stein TD, Brophy MT, Do NV, Ferguson RE, Priemer DS, Perl DP, Hickman RA, Nabors B, Rusiecki J, Barnholtz-Sloan JS, and Fillmore NR
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- Humans, Male, Female, United States epidemiology, Middle Aged, Adolescent, Young Adult, Adult, Veterans, Glioblastoma epidemiology, Glioblastoma therapy, Brain Neoplasms epidemiology, Brain Neoplasms therapy, Meningioma, Meningeal Neoplasms
- Abstract
Background: Comprehensive analysis of brain tumor incidence and survival in the Veteran population has been lacking., Methods: Veteran data were obtained from the Veterans Health Administration (VHA) Medical Centers via VHA Corporate Data Warehouse. Brain tumor statistics on the overall US population were generated from the Central Brain Tumor Registry of the US data. Cases were individuals (≥18 years) with a primary brain tumor, diagnosed between 2004 and 2018. The average annual age-adjusted incidence rates (AAIR) and 95% confidence intervals were estimated per 100 000 population and Kaplan-Meier survival curves evaluated overall survival outcomes among Veterans., Results: The Veteran population was primarily white (78%), male (93%), and between 60 and 64 years old (18%). Individuals with a primary brain tumor in the general US population were mainly female (59%) and between 18 and 49 years old (28%). The overall AAIR of primary brain tumors from 2004 to 2018 within the Veterans Affairs cancer registry was 11.6. Nonmalignant tumors were more common than malignant tumors (AAIR:7.19 vs 4.42). The most diagnosed tumors in Veterans were nonmalignant pituitary tumors (AAIR:2.96), nonmalignant meningioma (AAIR:2.62), and glioblastoma (AAIR:1.96). In the Veteran population, survival outcomes became worse with age and were lowest among individuals diagnosed with glioblastoma., Conclusions: Differences between Veteran and US populations can be broadly attributed to demographic composition differences of these groups. Prior to this, there have been no reports on national-level incidence rates and survival outcomes for Veterans. These data provide vital information that can drive efforts to understand disease burden and improve outcomes for individuals with primary brain tumors., (Published by Oxford University Press on behalf of the Society for Neuro-Oncology 2023.)
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- 2024
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3. CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2016-2020.
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Ostrom QT, Price M, Neff C, Cioffi G, Waite KA, Kruchko C, and Barnholtz-Sloan JS
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- Child, Male, Adolescent, Female, Humans, United States epidemiology, Incidence, Registries, Brain, Central Nervous System Neoplasms epidemiology, Brain Neoplasms epidemiology, Meningioma, Glioblastoma, Meningeal Neoplasms
- Abstract
The Central Brain Tumor Registry of the United States (CBTRUS), in collaboration with the Centers for Disease Control and Prevention and the National Cancer Institute, is the largest population-based registry focused exclusively on primary brain and other central nervous system (CNS) tumors in the United States (US) and represents the entire US population. This report contains the most up-to-date population-based data on primary brain tumors available and supersedes all previous CBTRUS reports in terms of completeness and accuracy. All rates are age-adjusted using the 2000 US standard population and presented per 100,000 population. The average annual age-adjusted incidence rate (AAAIR) of all malignant and non-malignant brain and other CNS tumors was 24.83 per 100,000 population (malignant AAAIR=6.94 and non-malignant AAAIR=17.88). This overall rate was higher in females compared to males (27.85 versus 21.62 per 100,000) and non-Hispanic persons compared to Hispanic persons (25.24 versus 22.61 per 100,000). Gliomas accounted for 26.3% of all tumors. The most commonly occurring malignant brain and other CNS histopathology was glioblastoma (14.2% of all tumors and 50.9% of all malignant tumors), and the most common predominantly non-malignant histopathology was meningioma (40.8% of all tumors and 56.2% of all non-malignant tumors). Glioblastomas were more common in males, and meningiomas were more common in females. In children and adolescents (ages 0-19 years), the incidence rate of all primary brain and other CNS tumors was 6.13 per 100,000 population. There were 86,030 deaths attributed to malignant brain and other CNS tumors between 2016 and 2020. This represents an average annual mortality rate of 4.42 per 100,000 population and an average of 17,206 deaths per year. The five-year relative survival rate following diagnosis of a malignant brain and other CNS tumor was 35.7%, for a non-malignant brain and other CNS tumor the five-year relative survival rate was 91.8%., (© The Author(s) 2023. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
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- 2023
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4. National-level overall survival patterns for molecularly-defined diffuse glioma types in the United States.
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Ostrom QT, Shoaf ML, Cioffi G, Waite K, Kruchko C, Wen PY, Brat DJ, Barnholtz-Sloan JS, and Iorgulescu JB
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- Humans, Prognosis, Mutation, Isocitrate Dehydrogenase genetics, Glioblastoma, Glioma pathology, Brain Neoplasms pathology, Astrocytoma, Oligodendroglioma
- Abstract
Background: Molecularly-defined diffuse glioma types-including IDH-wildtype glioblastoma, IDH-mutant astrocytoma, IDH-mutant 1p/19q-codeleted oligodendroglioma, and H3 K27M-mutant diffuse midline glioma-were incorporated into U.S. cancer registry reporting for individuals with brain tumors beginning in 2018. We leveraged these new data to estimate the national-level overall survival (OS) patterns associated with glioma integrated diagnoses., Methods: Individuals diagnosed with diffuse gliomas in 2018 and had brain molecular marker data were identified within the U.S. National Cancer Database. OS was estimated using Kaplan-Meier methods and stratified by WHO CNS grade, age, sex, tumor size, treatment, extent of resection, and MGMT promoter methylation. Additionally, the effects of WHO CNS grade were examined among individuals with IDH-wildtype astrocytic gliomas., Results: 8651 individuals were identified. One-year OS was 53.7% for WHO grade 4 IDH-wildtype glioblastomas; 98.0%, 92.4%, and 76.3% for WHO grade 2, 3, and 4 IDH-mutant astrocytomas, respectively; 97.9% and 94.4% for WHO grade 2 and 3 IDH-mutant 1p/19q-codeleted oligodendrogliomas, respectively; and 55.9% for H3 K27M-mutant diffuse midline gliomas. Among IDH-wildtype glioblastomas, median OS was 17.1 months and 12.4 months for methylated and unmethylated MGMT promoters. Additionally, IDH-wildtype diffuse astrocytic gliomas reported as WHO grade 2 or 3 demonstrated longer OS compared to grade 4 tumors (both P < .001)., Conclusions: Our findings provide the initial national OS estimates for molecularly-defined diffuse gliomas in the United States and illustrate the importance of incorporating such data into cancer registry reporting., (© The Author(s) 2022. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
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- 2023
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5. Mortality trends in primary malignant brain and central nervous system tumors vary by histopathology, age, race, and sex.
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Thierheimer M, Cioffi G, Waite KA, Kruchko C, Ostrom QT, and Barnholtz-Sloan JS
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- Adult, Humans, Child, United States epidemiology, Aged, Incidence, Brain, SEER Program, Central Nervous System Neoplasms epidemiology, Glioma, Glioblastoma
- Abstract
Purpose: Primary malignant brain and other central nervous system tumors are rare cancers that have shown rising mortality rates in recent years. To elucidate potential factors involved in this rising death rate, we examined mortality trends for primary malignant BT in the United States stratified by histopathology groupings, age, race, and sex., Methods: Mortality rates for demographic factors within primary malignant BT were generated using the National Center for Health Statistics' National Vital Statistics Systems data from 2004 to 2018. Additionally, histopathology-specific incidence-based mortality rates were calculated using the National Cancer Institute's Surveillance, Epidemiology, and End-Results (SEER) 18 data from 2004 to 2018. Joinpoint modeling was used to estimate mortality trends and annual percent changes with corresponding 95% confidence intervals., Results: Overall, there was a very small increase in mortality from 2004 to 2018. Individuals > 65 years saw a small increase in mortality, while changes in individuals of other ages were non-significant. Asian/Pacific Islander or American Indian/Alaskan Native had the largest increase in mortality. Among histopathology groupings, there was a small mortality increase in adults ages > 65 years with glioblastoma, while the mortality rate of other malignant gliomas declined in the same age group. CNS lymphoma mortality rates in patients ages 15-39 and 40-64 years declined significantly while rising significantly in the > 65 age group. In pediatric patients, embryonal tumor mortality had a non-significant increase between 2004 and 2007 but declined significantly between 2007 and 2018., Conclusion: Examining age, race, sex, and histopathology-specific mortality trends at the population level can provide important information for clinicians, researchers, and aid in public health planning., (© 2023. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)
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- 2023
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6. Influence of county-level geographic/ancestral origin on glioma incidence and outcomes in US Hispanics.
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Walsh KM, Neff C, Bondy ML, Kruchko C, Huse JT, Amos CI, Barnholtz-Sloan JS, and Ostrom QT
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- Adult, Child, Humans, Hispanic or Latino, Incidence, United States epidemiology, Astrocytoma ethnology, Glioblastoma ethnology, Glioma ethnology
- Abstract
Background: Glioma incidence is 25% lower in Hispanics than White non-Hispanics. The US Hispanic population is diverse, and registry-based analyses may mask incidence differences associated with geographic/ancestral origins., Methods: County-level glioma incidence data in Hispanics were retrieved from the Central Brain Tumor Registry of the United States. American Community Survey data were used to determine the county-level proportion of the Hispanic population of Mexican/Central American and Caribbean origins. Age-adjusted incidence rate ratios and incidence rate ratios (IRRs) quantified the glioma incidence differences across groups. State-level estimates of admixture in Hispanics were obtained from published 23andMe data., Results: Compared to predominantly Caribbean-origin counties, predominantly Mexican/Central American-origin counties had lower age-adjusted risks of glioma (IRR = 0.83; P < 0.0001), glioblastoma (IRR = 0.86; P < 0.0001), diffuse/anaplastic astrocytoma (IRR = 0.78; P < 0.0001), oligodendroglioma (IRR = 0.82; P < 0.0001), ependymoma (IRR = 0.88; P = 0.012), and pilocytic astrocytoma (IRR = 0.76; P < 0.0001). Associations were consistent in children and adults and using more granular geographic regions. Despite having lower glioma incidence, Hispanic glioblastoma patients from predominantly Mexican/Central American-origin counties had poorer survival than Hispanics living in predominantly Caribbean-origin counties. Incidence and survival differences could be partially explained by state-level estimates of European admixture in Hispanics with European admixture associated with higher incidence and improved survival., Conclusions: Glioma incidence and outcomes differ in association with the geographic origins of Hispanic communities, with counties of predominantly Mexican/Central American origin at significantly reduced risk and those of Caribbean origin at comparatively greater risk. Although typically classified as a single ethnic group, appreciating the cultural, socioeconomic, and genetic diversity of Hispanics can advance cancer disparities research., (Published by Oxford University Press on behalf of the Society for Neuro-Oncology 2022.)
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- 2023
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7. Molecular biomarker-defined brain tumors: Epidemiology, validity, and completeness in the United States.
- Author
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Iorgulescu JB, Sun C, Neff C, Cioffi G, Gutierrez C, Kruchko C, Ruhl J, Waite KA, Negoita S, Hofferkamp J, Tihan T, McLendon R, Brat DJ, Ostrom QT, and Barnholtz-Sloan JS
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- Young Adult, Adolescent, Child, Humans, United States, Biomarkers, Isocitrate Dehydrogenase genetics, Mutation, Brain Neoplasms pathology, Glioma pathology, Astrocytoma, Glioblastoma
- Abstract
Background: Selected molecular biomarkers were incorporated into the US cancer registry reporting for patients with brain tumors beginning in 2018. We investigated the completeness and validity of these variables and described the epidemiology of molecularly defined brain tumor types., Methods: Brain tumor patients with histopathologically confirmed diagnosis in 2018 were identified within the Central Brain Tumor Registry of the United States and NCI's Surveillance, Epidemiology, and End Results Incidence databases. The brain molecular markers (BMM) site-specific data item was assessed for coding completeness and validity. 1p/19q status, MGMT promoter methylation, WHO grade data items, and new ICD-O-3 codes were additionally evaluated. These data were used to profile the characteristics and age-adjusted incidence rates per 100 000 population of molecularly defined brain tumors with 95% confidence intervals (95% CI)., Results: BMM completeness across the applicable tumor types was 75%-92% and demonstrated favorable coding validity. IDH-wildtype glioblastomas' incidence rate was 1.74 (95% CI: 1.69-1.78), as compared to 0.14 for WHO grade 2 (95% CI: 0.12-0.15), 0.15 for grade 3 (95% CI: 0.14-0.16), and 0.07 for grade 4 (95% CI: 0.06-0.08) IDH-mutant astrocytomas. Irrespective of WHO grade, IDH mutation prevalence was highest in adolescent and young adult patients, and IDH-mutant astrocytomas were more frequently MGMT promoter methylated. Among pediatric-type tumors, the incidence rate was 0.06 for H3K27M-mutant diffuse midline gliomas (95% CI: 0.05-0.07), 0.03 for SHH-activated/TP53-wildtype medulloblastomas (95% CI: 0.02-0.03), and <0.01 for both C19MC-altered embryonal tumor with multilayered rosettes and RELA-fusion ependymomas., Conclusions: Our findings illustrate the success of developing a dedicated, integrated diagnosis variable, which provides critical molecular information about brain tumors related to accurate diagnosis., (Published by Oxford University Press on behalf of the Society for Neuro-Oncology 2022.)
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- 2022
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8. CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2015-2019.
- Author
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Ostrom QT, Price M, Neff C, Cioffi G, Waite KA, Kruchko C, and Barnholtz-Sloan JS
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- Adolescent, Adult, Brain, Child, Child, Preschool, Female, Humans, Incidence, Infant, Infant, Newborn, Male, Registries, United States epidemiology, Young Adult, Brain Neoplasms epidemiology, Central Nervous System Neoplasms epidemiology, Glioblastoma, Meningeal Neoplasms epidemiology, Meningioma epidemiology
- Abstract
The Central Brain Tumor Registry of the United States (CBTRUS), in collaboration with the Centers for Disease Control and Prevention and the National Cancer Institute, is the largest population-based registry focused exclusively on primary brain and other central nervous system (CNS) tumors in the United States (US) and represents the entire US population. This report contains the most up-to-date population-based data on primary brain tumors available and supersedes all previous reports in terms of completeness and accuracy. All rates are age-adjusted using the 2000 US standard population and presented per 100,000 population. The average annual age-adjusted incidence rate (AAAIR) of all malignant and non-malignant brain and other CNS tumors was 24.71 per 100,000 population (malignant AAAIR=7.02 and non-malignant AAAIR=17.69). This overall rate was higher in females compared to males (27.62 versus 21.60 per 100,000) and non-Hispanic persons compared to Hispanic persons (25.09 versus 22.95 per 100,000). The most commonly occurring malignant brain and other CNS histopathology was glioblastoma (14.2% of all tumors and 50.1% of all malignant tumors), and the most common non-malignant histopathology was meningioma (39.7% of all tumors and 55.4% of all non-malignant tumors). Glioblastoma was more common in males, and meningiomas were more common in females. In children and adolescents (ages 0-19 years), the incidence rate of all primary brain and other CNS tumors was 6.20 per 100,000 population. An estimated 93,470 new cases of malignant and non-malignant brain and other CNS tumors are expected to be diagnosed in the US population in 2022 (26,670 malignant and 66,806 non-malignant). There were 84,264 deaths attributed to malignant brain and other CNS tumors between 2015 and 2019. This represents an average annual mortality rate of 4.41 per 100,000 population and an average of 16,853 deaths per year. The five-year relative survival rate following diagnosis of a malignant brain and other CNS tumor was 35.7%, while for non-malignant brain and other CNS tumors the five-year relative survival rate was 91.8%., (© The Author(s) 2022. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
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- 2022
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9. Glioblastoma incidence rate trends in Canada and the United States compared with England, 1995-2015.
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Davis FG, Smith TR, Gittleman HR, Ostrom QT, Kruchko C, and Barnholtz-Sloan JS
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- Canada, England, Humans, Incidence, Life Style, United States, Brain Neoplasms, Glioblastoma
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- 2020
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10. Conditional survival after diagnosis with malignant brain and central nervous system tumor in the United States, 1995–2012
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Farah, Paul, Blanda, Rachel, Kromer, Courtney, Ostrom, Quinn T., Kruchko, Carol, and Barnholtz-Sloan, Jill S.
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- 2016
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11. Molecular marker testing and reporting completeness for adult-type diffuse gliomas in the United States.
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Neff, Corey, Cioffi, Gino, Waite, Kristin, Kruchko, Carol, Barnholtz-Sloan, Jill S, Ostrom, Quinn T, and Iorgulescu, J Bryan
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GLIOMAS ,BRAIN tumors ,COMMUNITY centers ,GLIOBLASTOMA multiforme ,ASTROCYTOMAS ,O6-Methylguanine-DNA Methyltransferase - Abstract
Background A newly developed brain molecular marker (BMM) data item was implemented by US cancer registries for individuals diagnosed with brain tumors in 2018—including IDH and 1p/19q-co-deletion statuses for adult-type diffuse gliomas. We thus investigated the testing/reporting completeness of BMM in the United States. Methods Cases of histopathologically confirmed glioblastoma, astrocytoma, and oligodendroglioma diagnosed in 2018 were identified in the National Cancer Database. Adjusted odds ratios (OR
adj ) and 95% confidence intervals (CI) of BMM testing/reporting were evaluated for association with the selected patient, treatment, and facility-level characteristics using multivariable logistic regression. As a secondary analysis, predictors of MGMT promoter methylation testing/reporting among IDH-wildtype glioblastoma individuals were assessed. Key limitations of the BMM data item were that it did not include any details regarding testing technique or assay type and could not distinguish between a lack of testing and a lack of cancer registry reporting of testing results. Results Among 8306 histopathologically diagnosed adult-type diffuse gliomas nationally, overall BMM testing/reporting completeness was 81.1%. Compared to biopsy-only cases, odds of testing/reporting increased for subtotal (ORadj = 1.38 [95% CI: 1.20–1.59], P <.001) and gross total resection (ORadj =1.50 [95% CI: 1.31–1.72], P <.001). Furthermore, the odds were lowest at community centers (hospitals (67.3%; ORadj =0.35 [95% CI: 0.26–0.46], P <.001) and highest at academic/NCI-designated comprehensive cancer centers (85.4%; referent). By geographical location, BMM testing/reporting completeness ranged from a high of 86.8% at New England (referent) to a low of 76.0 % in the West South Central region (ORadj =0.57 [95% CI: 0.42–0.78]; P <.001). Extent of resection, Commission-on-Cancer facility type, and facility location were additionally significant predictors of MGMT testing/reporting among IDH-wildtype glioblastoma cases. Conclusions Initial BMM testing/reporting completeness for individuals with adult-type diffuse gliomas in the United States was promising, although patterns varied by hospital attributes and extent of resection. [ABSTRACT FROM AUTHOR]- Published
- 2023
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12. Tumor Treating Fields for Glioblastoma Therapy During the COVID-19 Pandemic
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Gatson, Na Tosha N., Barnholtz-Sloan, Jill, Drappatz, Jan, Henriksson, Roger, Hottinger, Andreas F., Hinoul, Piet, Kruchko, Carol, Puduvalli, Vinay K., Tran, David D., Wong, Eric T., and Glas, Martin
- Subjects
Cancer och onkologi ,Oncology ,Medizinische Fakultät » Universitätsklinikum Essen » Klinik für Neurologie ,Cancer and Oncology ,Perspective ,Medizin ,glioblastoma ,COVID-19 ,ddc:610 ,elderly ,recurrent glioblastoma ,tumor treating fields - Abstract
Background: The COVID-19 pandemic has placed excessive strain on health care systems and is especially evident in treatment decision-making for cancer patients. Glioblastoma (GBM) patients are among the most vulnerable due to increased incidence in the elderly and the short survival time. A virtual meeting was convened on May 9, 2020 with a panel of neuro-oncology experts with experience using Tumor Treating Fields (TTFields). The objective was to assess the risk-to-benefit ratio and provide guidance for using TTFields in GBM during the COVID-19 pandemic. Panel Discussion: Topics discussed included support and delivery of TTFields during the COVID-19 pandemic, concomitant use of TTFields with chemotherapy, and any potential impact of TTFields on the immune system in an intrinsically immunosuppressed GBM population. Special consideration was given to TTFields' use in elderly patients and in combination with radiotherapy regimens. Finally, the panel discussed the need to better capture data on COVID-19–positive brain tumor patients to analyze longitudinal outcomes and changes in treatment decision-making during the pandemic. Expert Opinion: TTFields is a portable home-use device which can be managed via telemedicine and safely used in GBM patients during the COVID-19 pandemic. TTFields has no known immunosuppressive effects which is important during a crisis where other treatment methods might be limited, especially for elderly patients with multiple co-morbidities. It is too early to estimate the full impact of COVID-19 on the global healthcare system and on patient outcomes and the panel strongly recommended collaboration with existing cancer COVID-19 registries to follow CNS tumor patients. OA Förderung 2021
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- 2021
13. Association between urbanicity and surgical treatment among patients with primary glioblastoma in the United States.
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Cioffi, Gino, Cote, David J, Ostrom, Quinn T, Kruchko, Carol, and Barnholtz-Sloan, Jill S
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GLIOBLASTOMA multiforme ,CEREBELLAR tumors ,MEDICAL care ,SURGICAL excision ,HEALTH services accessibility ,BRAIN tumors - Abstract
Background Glioblastoma (GB) is the most common and most lethal primary malignant brain tumor. Extent of surgical resection is one of the most important prognostic factors associated with improved survival. Historically, patients living in nonmetropolitan counties in the United States have limited access to optimal treatment and health care services. The aim of this study is to determine whether there is an association between urbanicity and surgical treatment patterns among US patients with primary GB. Methods Cases with histologically confirmed, primary GB diagnosed between 2005 and 2015 were obtained from the Central Brain Tumor Registry of the United States (CBTRUS) in collaboration with the Centers for Disease Control and Prevention, and the National Cancer Institute. Multivariable logistic regression models were constructed to assess the association between urbanicity and receipt of surgical treatment (gross total resection [GTR]/subtotal resection [STR] vs biopsy only/none) and extent of resection (GTR vs STR), adjusted for age at diagnosis, sex, race, US regional division, and primary tumor site. Results Patients residing in nonmetropolitan counties were 7% less likely to receive surgical treatment (odds ratio [OR] = 0.93, 95% CI: 0.89-0.96, P <.0001). Among those who received surgical treatment, metropolitan status was not significantly associated with receiving GTR vs STR (OR = 0.99, 95% CI: 0.94-1.04, P =.620). Conclusions Among US patients with GB, urbanicity is associated with receipt of surgical treatment, but among patients who receive surgery, urbanicity is not associated with extent of resection. These results point to potential differences in access to health care for those in nonmetropolitan areas that warrant further exploration. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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14. Sex is an important prognostic factor for glioblastoma but not for nonglioblastoma.
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Gittleman, Haley, Ostrom, Quinn T, Stetson, L C, Waite, Kristin, Hodges, Tiffany R, Wright, Christina H, Wright, James, Rubin, Joshua B, Berens, Michael E, Lathia, Justin, Connor, James R, Kruchko, Carol, Sloan, Andrew E, and Barnholtz-Sloan, Jill S
- Subjects
OLIGODENDROGLIOMAS ,GLIOMAS ,PROPORTIONAL hazards models ,BRAIN tumors ,GLIOBLASTOMA multiforme - Abstract
Background Glioblastoma (GBM) is the most common and most malignant glioma. Nonglioblastoma (non-GBM) gliomas (WHO Grades II and III) are invasive and also often fatal. The goal of this study is to determine whether sex differences exist in glioma survival. Methods Data were obtained from the National Cancer Database (NCDB) for years 2010 to 2014. GBM (WHO Grade IV; N = 2073) and non-GBM (WHO Grades II and III; N = 2963) were defined using the histology grouping of the Central Brain Tumor Registry of the United States. Non-GBM was divided into oligodendrogliomas/mixed gliomas and astrocytomas. Sex differences in survival were analyzed using Kaplan–Meier and multivariable Cox proportional hazards models adjusted for known prognostic variables. Results There was a female survival advantage in patients with GBM both in the unadjusted (P =.048) and adjusted (P =.003) models. Unadjusted, median survival was 20.1 months (95% CI: 18.7-21.3 months) for women and 17.8 months (95% CI: 16.9-18.7 months) for men. Adjusted, median survival was 20.4 months (95% CI: 18.9-21.6 months) for women and 17.5 months (95% CI: 16.7-18.3 months) for men. When stratifying by age group (18-55 vs 56+ years at diagnosis), this female survival advantage appeared only in the older group, adjusting for covariates (P =.017). Women (44.1%) had a higher proportion of methylated MGMT (O
6 -methylguanine-DNA methyltransferase) than men (38.4%). No sex differences were found for non-GBM. Conclusions Using the NCDB data, there was a statistically significant female survival advantage in GBM, but not in non-GBM. [ABSTRACT FROM AUTHOR]- Published
- 2019
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15. Glioma incidence and survival variations by county-level socioeconomic measures.
- Author
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Cote, David J., Ostrom, Quinn T., Gittleman, Haley, Duncan, Kelsey R., CreveCoeur, Travis S., Kruchko, Carol, Smith, Timothy R., Stampfer, Meir J., Barnholtz‐Sloan, Jill S., and Barnholtz-Sloan, Jill S
- Subjects
OLIGODENDROGLIOMAS ,METROPOLITAN areas ,SURVIVAL analysis (Biometry) ,PACIFIC Islanders ,RURAL geography - Abstract
Background: Multiple studies have reported higher rates of glioma in areas with higher socioeconomic status (SES) but to the authors' knowledge have not stratified by other factors, including race/ethnicity or urban versus rural location.Methods: The authors identified the average annual age-adjusted incidence rates and calculated hazard ratios for death for gliomas of various subtypes, stratified by a county-level index for SES, race/ethnicity, US region, and rural versus urban status.Results: Rates of glioma were highest in counties with higher SES (rate ratio, 1.18; 95% CI, 1.15-1.22 comparing the highest with the lowest quintiles [P < .001]). Stratified by race/ethnicity, higher rates in high SES counties persisted for white non-Hispanic individuals. Stratified by rural versus urban status, differences in incidence by SES were more pronounced among urban counties. Survival was higher for residents of high SES counties after adjustment for age and extent of surgical resection (hazard ratio, 0.82; 95% CI, 0.76-0.87 comparing the highest with the lowest quintile of SES [P < .001]). Survival was higher among white Hispanic, black, and Asian/Pacific Islander individuals compared with white non-Hispanic individuals, after adjustment for age, SES, and extent of surgical resection, and when restricted to those individuals with glioblastoma who received radiation and chemotherapy.Conclusions: The incidence of glioma was higher in US counties of high compared with low SES. These differences were most pronounced among white non-Hispanic individuals and white Hispanic individuals residing in urban areas. Better survival was observed in high SES counties, even when adjusting for extent of surgical resection, and when restricted to those who received radiation and chemotherapy for glioblastoma. Differences in incidence and survival were associated with SES and race, rather than rural versus urban status. [ABSTRACT FROM AUTHOR]- Published
- 2019
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