Association Between Facility Volume and Overall Survival for Patients with Grade II Meningioma after Gross Total Resection

Chidinma P. Anakwenze, Susan McGovern, Nicolette Taku, Kaiping Liao, David R. Boyce-Fappiano, Carlos Kamiya-Matsuoka, Amol Ghia, Caroline Chung, Daniel Trifiletti, Sherise D. Ferguson, Jing Li, Debra Nana Yeboa

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: The role of adjuvant radiation after gross total resection (GTR) for grade II meningioma is evolving, prompting further evaluation in NRG-BN003, a phase 3 national trial. Furthermore, the relationship between facility volume and outcomes in patients with grade II meningioma after GTR has not been examined at a national level. We aim to assess overall survival (OS) of patients with grade II meningioma after GTR by surgical case volume and OS by receipt of adjuvant radiation. Methods: We used the National Cancer Database to identity 2823 patients diagnosed with grade II meningioma who underwent GTR. Propensity score matching was applied to balance covariates in patients with grade II meningioma after GTR stratified by adjuvant radiation status. Multivariable logistic regression was used to assess factors associated with radiation receipt. Kaplan-Meier and log-rank tests were used to assess OS by facility volume. Results: As facility volume increased, OS increased, with a 5-year OS of 72.8% for facilities with GTR grade II meningioma volumes of ≤8 cases per decade and 87.5% for >8 cases per decade (P < 0.0001). There was no difference in 5-year OS between GTR alone and GTR with adjuvant radiation (84.8% vs. 86.4%; P = 0.151). Covariates significantly associated with radiation receipt included facility location, facility volume, distance, and tumor size. Conclusions: Treatment at higher surgical case volume facilities is associated with improved OS for GTR grade II meningioma. These facilities also have more patients receiving adjuvant radiation. However, we observed no difference in OS between adjuvant radiation and surgery alone.

Original languageEnglish (US)
Pages (from-to)e133-e144
JournalWorld neurosurgery
Volume141
DOIs
StatePublished - Sep 2020

Keywords

  • Adjuvant radiation
  • Atypical meningioma
  • Facility volume
  • Grade II meningioma
  • Gross total resection
  • Survival

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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