A Retrospective Analysis of Surgical Meningioma Patients in an Underserved Population

Study Design: Retrospective study at a single academic institution.

Introduction: The role of healthcare disparities as it relates to neurosurgical disease processes is well documented in the literature, yet there is a lack of information regarding the presentation, management, and outcomes of patients with meningiomas that come from underserved areas.

Objective: The aim of this study is to describe the prevalence of high-grade intracranial meningiomas in an underserved population and assess the impact of healthcare access and socioeconomic issues as it relates to brain tumor pathology.

Methods: Surgical records were reviewed to identify patients diagnosed with an intracranial meningioma from 2008 to 2018 at a single institution. 95 patients who were diagnosed and treated surgically were identified after excluding for a lack of preoperative imaging, pathologic diagnosis, or a secondary resection. Descriptive statistics were performed to characterize this cohort.

Results: Mean age of the cohort was 59.8 years old (±12.9) and 67 patients (70.5%) were women. Mean body mass index was 31.3 kg/m² (±7.5), 37 patients (39.0%) had a history of smoking, and 25 patients (26.3%) were diabetic. The most common presenting symptoms were headache (54.7%) and seizure (32.6%). Median lesion volume was 35 cm³ (IQR: 16–79) at the time of surgery. 45 patients (47.9%) were diagnosed via neuropathology with benign meningiomas versus 49 patients (52.1%) with WHO grade II lesions. Gross-total resection was achieved in 59 (63.4%) of these patients and 8 patients (8.4%) required a secondary surgery for recurrence. Mean time to reoperation was 2.5 years (±2.2).

Conclusion: Underserved populations may present with a disproportionately high rate of high-grade meningiomas, suggesting that socioeconomic factors may influence access to care and diagnosis of benign asymptomatic lesions, and thus play a role in patients in this population presenting with more severe neuropathology.

No conflict of interest has been declared by the author(s).