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Associations of race and socioeconomic status with outcomes after intracranial meningioma resection: a systematic review and meta-analysis

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Abstract

Purpose

Social determinants of health broadly affect healthcare access and outcomes. Studies report that minorities and low socioeconomic status (SES) patients undergoing intracranial meningioma resection demonstrate worse outcomes and higher mortality rates. This systematic review and meta-analysis summarizes the available research reporting racial and SES disparities in intracranial meningioma resection outcomes.

Methods

A systematic review was conducted using PRISMA guidelines and included peer-reviewed, English-language articles from the United States between 2000 and 2022 that reported racial and SES disparities in meningioma outcomes. Outcomes included overall survival (OS), extent of resection (EOR), hospitalization costs, length of stay (LOS), 30-day readmission, recurrence, and receipt of surgery and adjuvant radiotherapy. A quantitative meta-analysis was performed only on survival outcomes by race. All other variables were summarized as a systematic review.

Results

633 articles were identified; 19 studies met inclusion criteria. Black or low SES patients were more likely to have increased hospitalization costs, rates of 30-day readmission, LOS, recurrence and less likely to undergo surgery, gross total resection, and adjuvant radiotherapy for their tumors. Six studies were used for the quantitative meta-analysis of race and OS. Compared to White patients, Black patients had significantly worse survival outcomes, and Asian patients had significantly better survival outcomes.

Conclusion

Disparities in outcomes exist for patients who undergo surgery for meningioma, such that Black and low SES patients have worse outcomes. The literature is quite sparse and contains confounding relationships not often accounted for appropriately. Further studies are needed to help understand these disparities to improve outcomes.

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Acknowledgements

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The authors declare that no funds, grants, or other support was received during the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Neurosurgery, Yale School of Medicine, New Haven, CT, USA

    Haoyi Lei, Joanna K. Tabor, Joseph O’Brien, Ruihan Qin, Alexandros F. Pappajohn, Miguel A. Millares Chavez, Saul F. Morales-Valero & Jennifer Moliterno

  2. The Chenevert Family Brain Tumor Center, Smilow Cancer Hospital, New Haven, CT, USA

    Haoyi Lei, Joanna K. Tabor, Joseph O’Brien, Ruihan Qin, Alexandros F. Pappajohn, Miguel A. Millares Chavez, Saul F. Morales-Valero & Jennifer Moliterno

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Contributions

JM, HL, and JKT contributed to the study conception and design. Material preparation, data collection, and analysis were performed by HL, JKT, JO, and RQ. The first draft of the manuscript was written by HL and JKT, and all figures and tables were prepared by HL. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Jennifer Moliterno.

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JM is a consultant for BK Medical. All other authors have no relevant financial or non-financial interests to disclose.

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Lei, H., Tabor, J.K., O’Brien, J. et al. Associations of race and socioeconomic status with outcomes after intracranial meningioma resection: a systematic review and meta-analysis. J Neurooncol 163, 529–539 (2023). https://doi.org/10.1007/s11060-023-04393-5

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