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ORIGINAL ARTICLE  CEREBRAL GLIOMA IN HIGHLY ELOQUENT AREAS: MANAGEMENT AND OUTCOME 

Journal of Neurosurgical Sciences 2019 April;63(2):114-20

DOI: 10.23736/S0390-5616.18.04598-8

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Gliomas: survival differences between metropolitan and non-metropolitan counties

Benjamin BEST 1, Ha S. NGUYEN 2, 3 , Ninh B. DOAN 4, Michael GELSOMINO 1, Saman SHABANI 1, Ghazaleh AHMADI JAZI 2, 3, Mohsen SADATI 2, 3, Sarvenaz SHEIKH 2, 3, Farzad H. ADL 2, 3, Muhammad A. TAQI 2, 3, Martin M. MORTAZAVI 2, 3

1 Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA; 2 California Institute of Neuroscience, Thousand Oaks, CA, USA; 3 National Skull Base Foundation, Thousand Oaks, CA, USA; 4 Department of Neurosurgery, Mitchell Cancer Institute, University of South Alabama, Mobile, AL, USA



BACKGROUND: For gliomas, metropolitan status has not been heavily explored in the context of short-term mortality or long-term observed survival. Larger populations are associated with proximity to academic universities/high-volume hospitals.
METHODS: The SEER-18 registry was queried for patients with gliomas. The patients were further classified into two population groups based on rural-urban continuum codes: metropolitan or non-metropolitan. Demographics and clinical factors were compared between both groups. For observed survival, univariate and multivariate analyses occurred with Cox proportional hazards model.
RESULTS: The non-metropolitan group constituted approximately 10.8% of all patients. Age at diagnosis of glioma was older for the non-metropolitan group compared to metropolitan group (51.60 years vs. 49.06 years). Relative to the metropolitan group, the non-metropolitan group exhibited a larger proportion of Caucasian, married, grade I and IV gliomas, no surgery, no GTR (for those who had surgery), and temporal/parietal/occipital locations. Other covariates (sex, tumor size, laterality, and radiation status) did not exhibit significant differences in proportions. From analysis of observed survival, independent predictors include population group, as well as age, gender, marital status, tumor location, tumor grade, laterality, GTR, and receipt of radiation. Short-term mortality was 11.68% and 13.04% for Metropolitan and non-metropolitan groups, respectively. Median survival was 15 months and 12 months for Metropolitan and non-metropolitan groups, respectively.
CONCLUSIONS: About one-tenth of gliomas are treated at non-metropolitan sites. Key differences exist among patient/glioma characteristics based on metropolitan status. Overall, metropolitan status appears to influence short-term mortality and long-term observed survival for gliomas.


KEY WORDS: SEER Program - Glioma - Survival

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