Senior Member Moffitt Cancer Center Tampa, Florida, United States
Introduction: Health disparities are prevalent among cancer patients of different races and socioeconomic statuses. For example, Black women have a 12% higher overall cancer mortality than White women, despite an 8% lower incidence rate. Gliomas are CNS tumors associated with significant morbidity and mortality, and overall poor prognosis. Health disparities affecting this population are emerging but remain incomplete.
Methods: A retrospective chart review was conducted of all patients with primary brain gliomas that underwent craniotomy at our National Cancer Institute-designated comprehensive cancer center from 2008 to 2018. Data collected includes basic demographic data; tumor types, grades, and locations; and operative and clinical characteristics. Multivariable analysis was completed on the 635 patients who met inclusion criteria. Odds Ratios were calculated.
Results: Men have a 1.975x greater risk of mortality than women (p = 0.009; 95% CI 1.184 – 3.295). Older patients have a 1.062x greater risk of mortality than younger patients (95% CI 1.042 – 1.083). Patients who underwent surgery for a recurrent tumor have a 3.479x greater risk of mortality than patients who underwent surgery for a primary tumor (95% CI 1.951 – 6.206). Patients with preoperative cranial nerve deficits have a 3.590x greater risk of mortality than patients without (p = 0.007; 95% CI 1.411 – 9.134). Non-Caucasians have 0.325x the risk of mortality compared to Caucasians (p = 0.006; 95% CI 0.146 – 0.722). Finally, the longer the delay between date of diagnosis and date of surgery, the higher the mortality (p = 0.036).
Conclusion : Expected risks of mortality included patients who are older, undergoing surgery for recurrent tumors, with preoperative cranial nerve deficits, or those who experienced a longer delay between date of diagnosis and surgery. Surprisingly, non-Caucasians had a decreased risk of mortality compared to Caucasians. These findings highlight potential modifiable factors to reduce disparities in glioma patients undergoing craniotomy.
