Trends in Survival Rates for Primary Brain and CNS Tumors in the US, 2004–2017
Overview
This study analyzed survival trends for primary brain and central nervous system tumors in the United States from 2004 to 2017 using data from the CDC’s NPCR. It highlights variations in 5-year relative survival rates by age, tumor behavior, histopathology, and treatment patterns, revealing improvements and persistent disparities.
Background
Primary brain and CNS tumors include both malignant and non-malignant types, with non-malignant tumors occurring more than twice as frequently. Survival rates vary significantly by age group, tumor histopathology, and demographic factors such as sex and race/ethnicity. Surgical resection remains the primary treatment, often combined with radiation and chemotherapy. Despite advances, optimal treatment strategies for many tumor types remain unclear, and survival outcomes differ widely across tumor subtypes and patient populations.
Survival rates by tumor site: Acoustic nerve tumors have the highest 5-year survival (99.5%), while parietal lobe and overlapping brain lesions have the lowest (25.2%). Histopathology survival ranges from pilocytic astrocytoma (94.7%) to glioblastoma (6.8%).
Key Findings
Overall 5-year relative survival for primary malignant brain and CNS tumors was 66.9% from 2001 to 2017.
Children (0–14 years) and adolescents/young adults (15–39 years) have higher 5-year survival rates than adults aged 40 years and older.
Females generally have better survival outcomes than males, while Black non-Hispanic individuals have poorer survival compared to non-Hispanic Whites.
Survival varies widely by tumor site and histopathology, with pilocytic astrocytoma showing the best prognosis and glioblastoma the worst.
Surgical resection extent positively influences survival; combined radiation and temozolomide improved glioblastoma survival by 2.5 months compared to single modality treatments.
Survival trends were analyzed across three time periods (2004–2007, 2008–2012, 2013–2017) and stratified by age, race/ethnicity, and treatment patterns.
Clinical Implications
Clinicians should consider age, tumor histopathology, and demographic factors when prognosticating and planning treatment for brain and CNS tumors. Surgical resection remains critical, and combined modality therapy can improve outcomes in certain tumor types like glioblastoma. Awareness of survival disparities by race and sex may guide more personalized approaches and targeted interventions.
Conclusion
Survival rates for primary brain and CNS tumors vary substantially by age, tumor type, and demographic factors, with some improvements over time. Continued research and tailored treatment strategies are essential to improve outcomes, especially for high-risk groups and aggressive tumor subtypes.
References
CBTRUS 2021 Annual Report -- Primary Brain and CNS Tumor Statistics in the US
Stupp et al. 2005 -- Radiotherapy plus Concomitant and Adjuvant Temozolomide for Glioblastoma
CDC NPCR -- National Program of Cancer Registries Survival Database
