%0 Journal Article %T Trends in Management of Intracranial Meningiomas: Analysis of 49,921 Cases from Modern Cohort. %A Agarwal V %A McCutcheon BA %A Hughes JD %A Carlson ML %A Glasgow AE %A Habermann EB %A Nguyen QB %A Link MJ %A Van Gompel JJ %J World Neurosurg %V 106 %N 0 %D Oct 2017 %M 28666914 %F 2.21 %R 10.1016/j.wneu.2017.06.127 %X OBJECTIVE: We sought to characterize patterns and treatment for intracranial meningiomas in the Surveillance, Epidemiology, and End Results set of cancer registries.
METHODS: SEER data was queried from 2004-2012 for cases of intracranial meningioma using appropriate topography and histology codes.
RESULTS: A total of 49,921 patients with intracranial meningioma were identified. The vast majority of cases were associated with a benign histology (n = 47,047, 94.2%). There were 21,145 patients (42.4%) who underwent surgical management, 2783 who received radiation alone (5.6%), and 25,993 who underwent surveillance only (52.1%). Surgical management decreased in frequency from 48.8% of all cases in 2004 to 38.3% of cases in 2012 (P < 0.001). Radiation alone remained stable over time with a range of 4.8%-6.3% of cases. Observation increased from 45.0% of cases in 2004 to 56.7% of cases in 2012 (P < 0.001). On unadjusted analysis, surgical management was associated with younger age and larger tumor size. The incidence of tumors <2 cm in size increased significantly over the study period from 29.7% in 2004 to 41.7% in 2012 (P < 0.001). After adjusting for tumor size, multivariable analysis demonstrated that the odds of observation as a primary management strategy were greater in 2012 relative to 2004 (odds ratio 1.33, 95% confidence interval 1.21-1.45).
CONCLUSIONS: The incidence of intracranial meningiomas increased, while tumor size at the time of diagnosis decreased. Moreover, the number undergoing no treatment increased as a treatment strategy and was more likely employed for older patients, those of African-American race, and those with smaller tumors.