Treatment and survival of patients with nonmalignant intracranial meningioma: results from the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute

OBJECT: The authors conducted a study to determine population-based estimates of survival following the diagnosis and treatment of nonmalignant intracranial meningioma in the US in the modern era. METHODS: Patients with nonmalignant intracranial meningioma were identified through the Surveillance, Epidemiology, and End Results (SEER) database for the years 2004-2007. Predictors of undergoing resection were identified and odds ratios calculated. Estimates of survival were calculated using Kaplan-Meier estimation method and Cox proportional hazards model. RESULTS: There were 12,284 patients with a diagnosis of nonmalignant intracranial meningioma included in the analysis. Only 55% had histological confirmation of the diagnosis of nonmalignant meningioma. Resection was used as an initial treatment in 43% of cases. Patients treated with surgery were more likely to be younger (OR 9.3, 95% CI 8.1-10.7, for resection in patients age 40-59 years compared with age > 80 years), male (OR 1.4, 95% CI 1.3-1.5, for males compared with females), white (OR 0.8, 95% CI 0.7-0.9, for black patients compared with white patients), and have larger tumors (OR 11.8, 95% CI 10.3-13.6, for tumors of the largest quartile compared with the smallest quartile). Patients treated with resection had a 3-year postdiagnosis survival estimate of 93.4% (95% CI 92.5%-94.3%) compared with 88.3% (95% CI 85.5%-90.6%) in patients not treated with resection (p < 0.01). Younger patient age, female sex, unilateral tumors, and resection were predictors of improved postdiagnosis survival after multivariate adjustment in patients with histologically confirmed meningiomas. conclusions: This analysis represents the first modern population-based analysis of treatment patterns and outcomes in US patients with nonmalignant intracranial meningioma. Over 85% of patients survive 3 years after diagnosis, and resection is associated with improved survival.