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Incidence trends and survival analysis of atypical meningiomas: a population-based study from 2004 to 2018
Matthew J Recker1,2, Cathleen C Kuo3, Dheerendra Prasad1,2,4,5
1Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, 100 High Street, Suite B4, Buffalo, NY, 14203, USA.
Purpose:
Atypical meningiomas have histologic and clinical features that fall between those for benign and malignant meningiomas. The incidence of atypical meningiomas has not been well studied with respect to changes in the World Health Organization (WHO) classification scheme over time.
Methods:
The National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database was queried to obtain data from 2004 to 2018 for patients with all meningiomas, including atypical. Age-adjusted incidence rates were generated and annual percent change (APC) in the incidence rates was calculated with joinpoint regression. Survival was analyzed using the Kaplan-Meier method and Cox proportional hazards models.
Results:
A total of 4476 patients diagnosed with meningioma were identified from the SEER 18 registries. The incidence of atypical meningioma increased at an APC of 5.6% [95% confidence interval [CI], 3.4-7.8]; significantly faster than all meningiomas, which rose at an APC of 2.5% (95%CI 1.8-3.1;p = 0.008). For atypical meningiomas, the 1, 3, 5, and 10-year survival rates were 91.9%, 81.3%, 68.8%, and 34.3%, respectively. Male sex, older age (≥ 60 years), and large tumor size (> 5 cm) were independent risk factors for an unfavorable prognosis.
Conclusions:
The incidence of atypical meningioma was observed to be increasing relative to all meningiomas. It is important to diligently monitor atypical meningioma incidence and mortality rates over time to see whether observed uptrends persist. Continued effort toward improving outcomes in patients with atypical meningiomas is warranted, especially in light of an apparent rise in incidence.
Insights
The incidence of atypical meningioma is increasing faster than all meningiomas. Continued monitoring and improved outcomes for atypical meningioma patients are crucial due to this rising trend.
Area of Science:
- Neuro-oncology
- Epidemiology
- Cancer Research
Background:
- Atypical meningiomas present intermediate features between benign and malignant types.
- The incidence trends of atypical meningiomas, particularly concerning World Health Organization (WHO) classification changes, require further investigation.
Purpose of the Study:
- To analyze the incidence trends of atypical meningiomas in comparison to all meningiomas.
- To evaluate survival rates and identify prognostic factors for atypical meningioma patients.
Main Methods:
- Utilized the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database (2004-2018).
- Calculated age-adjusted incidence rates and annual percent change (APC) using joinpoint regression.
- Analyzed survival using Kaplan-Meier method and Cox proportional hazards models.
Main Results:
- Atypical meningioma incidence increased significantly faster (APC 5.6%) than all meningiomas (APC 2.5%).
- 1, 3, 5, and 10-year survival rates for atypical meningiomas were 91.9%, 81.3%, 68.8%, and 34.3%, respectively.
- Male sex, older age (≥60 years), and large tumor size (>5 cm) were independent risk factors for poor prognosis.
Conclusions:
- Atypical meningioma incidence is rising relative to all meningiomas.
- Ongoing surveillance of atypical meningioma incidence and mortality is essential to confirm persistent uptrends.
- Enhanced efforts to improve outcomes for atypical meningioma patients are necessary given the increasing incidence.
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