Sex Differences in Time to Treat and Outcomes for Gliomas.
National Cancer Database
glioblastoma
gliomas
outcomes
sex differences
treatment
Journal
Frontiers in oncology
ISSN: 2234-943X
Titre abrégé: Front Oncol
Pays: Switzerland
ID NLM: 101568867
Informations de publication
Date de publication:
2021
2021
Historique:
received:
17
11
2020
accepted:
04
01
2021
entrez:
8
3
2021
pubmed:
9
3
2021
medline:
9
3
2021
Statut:
epublish
Résumé
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. 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 glioma. Glioblastoma (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. A 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). Based 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.
Sections du résumé
BACKGROUND
BACKGROUND
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. 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 glioma.
METHODS
METHODS
Glioblastoma (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.
RESULTS
RESULTS
A 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).
CONCLUSIONS
CONCLUSIONS
Based 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.
Identifiants
pubmed: 33680971
doi: 10.3389/fonc.2021.630597
pmc: PMC7933512
doi:
Types de publication
Journal Article
Langues
eng
Pagination
630597Informations de copyright
Copyright © 2021 Stabellini, Krebs, Patil, Waite and Barnholtz-Sloan.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Références
Neurosurg Clin N Am. 2019 Jan;30(1):1-16
pubmed: 30470396
J Neurosurg. 2019 Feb 15;132(2):491-502
pubmed: 30771780
J Clin Neurosci. 2018 Jan;47:103-110
pubmed: 29113851
Cancer. 2006 Mar 15;106(6):1358-63
pubmed: 16470608
JAMA. 2013 Nov 6;310(17):1842-50
pubmed: 24193082
J Clin Invest. 2014 Sep;124(9):4123-33
pubmed: 25083989
Neuro Oncol. 2019 Nov 1;21(Suppl 5):v1-v100
pubmed: 31675094
Neurooncol Pract. 2019 Jan;6(1):37-46
pubmed: 30740232
Neurooncol Pract. 2019 Dec;6(6):451-462
pubmed: 31832215
Neuro Oncol. 2018 Mar 27;20(4):576-577
pubmed: 29474647
Oncologist. 2014 Apr;19(4):403-13
pubmed: 24664484
World Neurosurg. 2018 Apr;112:e342-e347
pubmed: 29337169
Biomol Ther (Seoul). 2018 Jul 1;26(4):335-342
pubmed: 29949843
Semin Oncol Nurs. 2018 Dec;34(5):420-429
pubmed: 30392758
CA Cancer J Clin. 2017 Jan;67(1):7-30
pubmed: 28055103
J Neurooncol. 2016 Jun;128(2):241-50
pubmed: 26970981
BMC Cancer. 2020 May 19;20(1):447
pubmed: 32429869
Cancer Epidemiol Biomarkers Prev. 2020 Jul;29(7):1389-1397
pubmed: 32349967
Eur J Cancer. 2009 Apr;45(6):1017-27
pubmed: 19109009