Survival in Patients with High-Grade Spinal Meningioma: An Analysis of the National Cancer Database

Objective: To report baseline demographics and examine for differences in survival for patients with World Health Organization (WHO) grade II and III spinal meningioma. Methods: The National Cancer Database was queried for patients diagnosed with WHO grade II or grade III spinal meningioma between 2004 and 2015. Cases with histopathological confirmation were included. Descriptive statistics were calculated and stratified by tumor type. Facility type, 30-day readmission, and 90-day mortality were also examined. Crude and adjusted Cox proportional hazards regression models were used to evaluate for differences in survival. Results: A total of 287 patients with WHO grade II or grade III spinal meningioma (white, n = 237; black, n = 32; Asian and Pacific Islander, n = 11; unknown race, n = 7) were identified. The mean patient age was 56.4 years, and the majority were female (70%; n = 201). Almost one-half of the patients were treated in an academic/research program (45.3%; n = 130,). Those with WHO grade III lesions received the earliest treatment, at a mean of 10.8 days following diagnosis. The proportion of patients with unplanned 30-day readmission following surgery was 4.2% (n = 12). Two patients died within 90 days of surgery. Multivariable analysis demonstrated no differences in survival for patients with WHO grade II or grade III lesions (hazard ratio, 2.01; 95% confidence interval, 0.89–4.52; P = 0.09). Conclusions: No difference in overall survival was identified between patients with WHO grade II or III spinal meningioma, although a trend was seen toward worse survival for patients with WHO grade III lesions.