Medical Student Boston University School of Medicine Boston, MA, US
Introduction: Despite representing only 2% of tumors, the overall five-year survival rate of patients presenting with brain tumors is only 36%. Additionally, these rates vary significantly based on patient demographic, presentation, and surgical treatment. Thus, understanding the patient population is vital for optimally design treatment approaches in brain tumor resection. In this study, we present findings across all operative brain tumors at a large, diverse, safety-net hospital.
Methods: We performed a preliminary retrospective study at New England’s largest, safety net hospital and level 1 trauma center. Demographic, clinical, and outcome data was collected from all operative brain tumors between 2013 and 2024.
Results: A total of 215 patients were included in the preliminary analysis. The mean age of patients was 52.9 years, 53% were female, 61% were non-white minorities, 35% were primarily non-English speaking, 37.9% were on Medicaid/Medicare, and 14.8% were uninsured. Social history revealed that 9.3% of patients were IV drug users, 10.7% had alcohol use disorder, and 39.5% were smokers. Medical co-morbidities included psychiatric conditions in 37.8%, hypertension in 50.2% and diabetes in 23.4%. At presentation, mean ECOG score was 1.79, Karnofsky Performance Score 69.2, and mRS 2.08. Healthcare proxy forms were completed in 42.3% of patients before surgery. Tumor makeup included 18.6% high grade glioma, 28.4% meningioma, 20.9% pituitary adenoma, 19.5% metastases, and 12.6% other. Median time between presentation and surgery was 0.7 (IQR 0.23–3.5) months and the median length of stay was 10 (IQ 5–17) days.
Conclusion : The patient population presenting for neurosurgical brain tumor care is highly demographically and clinically diverse. There is a higher acuity of presentation and findings compared to national averages, especially with respect to presence of psychiatric comorbidities and median time from presentation to surgery.
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