Abstract
BackgroundGliomas are the most common type of primary malignant brain tumor in adults, representing one third of all primary and central nervous system (CNS) tumors and 80% of malignant tumors diagnosed in the Western world. Epidemiological data indicate that the overall incidence and mortality of cancer is higher in males, while females have a better prognosis. The goal of this study is to determine whether there are sex differences in the time to treat and clinical outcomes in patients with gliomaMethodsGlioblastoma (GB) and Lower Grade Glioma (LGG) patients were defined per the Central Brain Tumor Registry of the United States (CBTRUS) from the National Cancer Database (NCDB) for diagnosis years 2004 to 2016. Associations between sex and time to treatment variables as well as associations between sex and multiple clinical outcomes were assessed using univariable and multivariable models.ResultsA total of 176,100 patients were used for analysis (124,502 GBM and 51,598 LGG). Males had a statistically significant association with >7 days to surgery (OR = 1.09, CI 1.05–1.13, p < 0.001) but this association was not observed in the multivariable model (OR = 1.05, CI 0.96–1.16, p = 0.25). After adjustment for key variables including time to treat variables, males with GB and LGG had a higher risk of death (HR = 1.11, CI 1.09–1.13, p < 0.001, HR = 1.09, CI 1.03–1.15, p < 0.001; respectfully). Sex differences in 90-day mortality for GBM were not found after adjustment (OR for males = 0.99, CI 0.91–1.08, p = 0.93). For LGG, both the univariable and multivariable logistic regression models showed no sex differences in 90-day mortality (OR for males = 1.03, CI 0.94–1.12, p = 0.45; multivariable OR for males = 0.81, CI 0.62–1.06, p = 0.13).ConclusionsBased on NCDB data, there were no statistically significant differences in time to treatment between males and females, however males had a higher proportion of GB and LGG as well as a higher risk of death compared to females.
Highlights
Gliomas are the most common type of primary malignant brain tumor in adults [1]
Data were obtained from the National Cancer Database (NCDB) for diagnosis years 2004 to 2016, a clinical oncology database sourced from hospital registry data that are collected in more than 1,500 Commission on Cancer (CoC) accredited facilities
GB and LGG patients were defined per the Central Brain Tumor Registry of the United States (CBTRUS) [1], with International Classification of Disease–Oncology histological codes 9440/3, 9441/3, and 9442/3 for GB and 9400/3, 9410/3, 9411/3, 9420/3, 9401/3, 9450/3, 9451/3, 9460/3, and 9382/3 for LGG
Summary
Gliomas are the most common type of primary malignant brain tumor in adults [1]. These tumors represent one third of all primary and central nervous system (CNS) tumors and 80% of malignant tumors diagnosed in the Western world [2]. LGGs are more common in younger individuals, following an indolent course and have a good prognosis [8], with a 5-year survival rate reaching values of 98% [3, 8]. Gliomas are the most common type of primary malignant brain tumor in adults, representing one third of all primary and central nervous system (CNS) tumors and 80% of malignant tumors diagnosed in the Western world. The goal of this study is to determine whether there are sex differences in the time to treat and clinical outcomes in patients with glioma
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