789 The Impact of Social Determinants on Adjuvant Radiation Following Atypical Meningioma Surgery

Abstract

INTRODUCTION: WHO grade 2 meningiomas or ‘atypical meningiomas’ are a subset of meningioma associated with higher morbidity and mortality. Adjuvant radiotherapy is increasingly shown to improve survival and reduce recurrence in these tumors. METHODS: The National Cancer Database was queried for patients receiving atypical meningioma surgery between 2004 and 2019. Univariate association, univariate regression and multivariate regression were performed on 8,654 patients to assess the association between receipt of adjuvant radiation and social determinants. Secondarily, KM curves were used to compare overall patient survival between those that received radiation and those that did not. RESULTS: Adjuvant radiation was less likely to be administered to patients over age 65 (95% CI = 0.53-0.77) and more likely to be administered to males (95% CI = 1.07–1.38). Compared to the Southern USA, patients were more likely to receive radiotherapy in the Northeastern (95% CI = 1.40–2.05), Midwestern (95% CI =1.06–1.54), and Western parts of the United States (95% CI = 1.31–2.00). Patients residing furthest from the reporting facility were less likely to receive radiation (95% CI = 0.65–0.98). Patients with any kind of insurance were more likely to receive radiation (p = 0.048) than those without insurance. On multivariate analysis, no differences were found between racial groups regarding adjuvant radiation, however the univariate analysis demonstrated that compared to non-hispanic whites, non-hispanic blacks were less likely to receive radiation (95% CI = 0.64-0.94) and Asian/Pasic Islanders were more likely to receive radiation (95% CI = 1.03–1.79). CONCLUSIONS: We reveal that disparities in administration of adjuvant RT exist based on female sex, age > 65, uninsured status, distance from the treating facility, and facility regional location.