Meningioma Characteristics Influencing Overall Survival by Race and Ethnicity

Abstract

Background There are known racial and ethnic disparities affecting overall survival (OS) in meningiomas. This has largely been presumed to be due to differences in socioeconomic status (SES). However, there are conflicting studies that demonstrate better survival for Hispanic compared to Black populations, two groups with similar SES. Thus, we hypothesize additional underlying factors, including tumor biology, may differ amongst race and influence OS of patients with meningioma. Methods We queried the NCDB for patients with pathology-confirmed meningiomas from 2012-2020. Race and ethnicity were self-reported and grouped into White, Hispanic White, Black, Hispanic Black, and Asian categories. Logistic regression analyses were performed to determine tumor and patient characteristics associated with race and Cox hazards model was performed on these characteristics to determine influence on OS. Results We included 85,244 patients in this study. Black patients have worse OS compared to White patients. Black patients were also more likely to harbor higher grade tumors and undergo subtotal resection compared to White patients. Hispanic White patients had improved overall survival (P<0.0001) with less higher-grade tumors (P=0.0051) compared to White patients. There was no difference in overall survival for Hispanic Black patients (P=0.49) despite being more likely to have higher grade tumors (P=0.0164). Conclusions Differences in meningioma biology may contribute to the differences in OS seen in racial groups beyond SES. Black patients are a particularly vulnerable group as they tend to harbor higher-grade tumors and undergo less aggressive surgical resections. Further studies are necessary to determine possible differences in underlying biology.