Changes in survival over time for primary brain and other CNS tumors in the United States, 2004-2017

J Neurooncol. 2022 Oct;160(1):209-219. doi: 10.1007/s11060-022-04138-w. Epub 2022 Oct 5.

Abstract

Purpose: Despite advances in cancer diagnosis and clinical care, survival for many primary brain and other central nervous system (CNS) tumors remain poor. This study performs a comprehensive survival analysis on these tumors.

Methods: Survival differences were determined utilizing the National Program of Cancer Registries Survival Analytic file for primary brain and CNS tumors. Overall survival and survival of the 5 most common histopathologies, within specific age groups, were determined. Overall survival was compared for three time periods: 2004-2007, 2008-2012, and 2013-2017. Survival differences were evaluated using Kaplan-Meier and multivariable Cox proportional hazards models. Models were adjusted for sex, race/ethnicity, and treatment. Malignant and non-malignant brain tumors were assessed separately.

Results: Among malignant brain and CNS tumor patients overall, there were notable differences in survival by time period among all age groups. Similar differences were noted in non-malignant brain and CNS tumor patients, except for adults (aged 40-64 years), where no survival changes were observed. Survival differences varied within specific histopathologies across age groups. There were improvements in survival in 2008-2012 and 2013-2017, when compared to 2004-2007, in children, AYA, and older adults with malignant tumors, and among older adults with non-malignant tumors.

Conclusion: Overall survival for malignant brain and other CNS tumors improved slightly in 2013-2017 for all age groups as compared to 2004-2007. Significant changes were observed for non-malignant brain and other CNS tumors among older adults. Information regarding survival over time can be utilized to identify population level effects of diagnostic and treatment improvements.

Keywords: Brain tumors; Central nervous system tumors; Epidemiology; Survival.

MeSH terms

  • Aged
  • Brain
  • Brain Neoplasms* / diagnosis
  • Brain Neoplasms* / epidemiology
  • Brain Neoplasms* / therapy
  • Central Nervous System Neoplasms* / epidemiology
  • Central Nervous System Neoplasms* / therapy
  • Child
  • Humans
  • Incidence
  • Registries
  • Survival Rate
  • United States / epidemiology