Epidemiology of meningiomas post‐Public Law 107‐206: The Benign Brain Tumor Cancer Registries Amendment Act

Abstract

Purpose Our analysis follows the implementation of Public Law 107–260, the Benign Brain Tumor Cancer Registries Act mandating collection of non-malignant brain tumors including meningiomas. Methods Meningiomas were selected from the Surveillance, Epidemiology, and End Results (SEER) Program database for 2004–2011. Demographic and clinical characteristics, initial treatment patterns, and survival outcomes were evaluated. Results The average annual age-adjusted incidence rates were 7.62 per 100,000 population, 7.50 non-malignant (7.18 benign; 0.32 borderline malignancy), and 0.12 malignant. Annual rates increased for benign and borderline malignancy but decreased for malignant tumors. Female rates exceeded male rates and were even twice those for benign tumors. Black rates were significantly higher than other races for all three behavior types. Rates increased with advancing age. More than 80% tumors were located in cerebral meninges. Diagnostic confirmation through pathology occurred for about 50% benign, 90% borderline malignancy, and 80% malignant tumors. No initial treatment was reported for approximately 60% benign, 30% borderline malignancy, and 30% malignant meningiomas. Five-year relative survival estimates for benign, borderline malignancy, and malignant were 85.6%, 82.3%, and 66.0%, respectively. Predictors of poorer survival were advanced age, male, black race, no initial treatment, and malignant behavior whereas younger age, female, spinal meningioma, any initial treatment and benign or borderline malignancy were associated with better survival. Conclusion Our analysis demonstrates an increasing incidence of non-malignant meningiomas at the population level. Treatment patterns and survival outcomes is concerning for a substantial percentage not receiving surgical or radiation treatments for higher grade meningiomas.

Individual-patient prediction of meningioma malignancy and survival using the Surveillance, Epidemiology, and End Results database

“…Also concordant with previous reports, black race and larger tumor size were found to be adverse prognostic factors. 3,22,23 Regarding lateralization, we found that the proportion of malignant/borderline malignant tumors was greater for bilateral meningiomas. This effect is presumably explained by size as bilateral tumors were on average larger (41.5 mm) than midline (30.0 mm) or unilateral (27.2 mm) tumors.…”

Early or late radiotherapy following gross or subtotal resection for atypical meningiomas: Clinical outcomes and local control

“…Meningiomas have become increasingly prevalent [21] in the United States as the general population ages and as the use of brain imaging has become more prevalent. While the majority of these tumors are benign with relatively good outcomes [22], a significant proportion are AMs with more aggressive pathology and worse outcomes [18,23–25].…”

Sellar and Parasellar Imaging

“…31 They are 3 times more common in females and are largely tumors of adulthood, with greater than 70% occurring after age 55. 31 Meningiomas are rarely seen in children unless syndromic or associated with radiation (less than 2% occur in patients 20 yr of age or younger). 32 With 15 subtypes in the 2007 WHO classification, they are histologically heterogeneous, although most (90%) are benign and classified as grade I.…”