Survival
Plotted survival curves (Figure 1) for pediatric brain tumors showed
disparities in survival across racial/ethnic groups (p<0.001).
Overall median survival for all pediatric brain and CNS tumors (Fig. 1A)
was 53 months (95% CI, 50-55). Non-Hispanic whites had better survival
(Fig. 1B) with a median of 62 months (95% CI, 59-65). The remaining
three racial groups had a worse survival with non-Hispanic blacks having
a median survival of 41 months (95% CI, 34-47) and Hispanics and
“Other” racial/ethnic groups both experiencing a median survival of 40
months (Table 2). When stratified by histology, anaplastic astrocytoma
and Glioblastomas had the worst survival (Fig. 1C) with an overall
median survival of 14 months (95% CI, 13-15). There were statistically
significant differences in survival by race/ethnicity within these
histologic sub-types (p=0.0001) with Hispanics and non-Hispanic blacks
having a worse survival than non-Hispanic whites and Other. Children
diagnosed with diffuse astrocytoma (protoplasma, fibrillary) and Mixed
glioma (Fig. 1D), had a good prognosis with an overall median survival
of 89 months (95% CI, 80-98) with no statistically significant
differences across racial/ethnic groups (p=0.2908).
Multivariate adjustment of the model also revealed non-Hispanic black
[adjusted Hazard Ratio (aHR) 1.12(1.04-1.21)], Hispanic [aHR 1.25(
1.18- 1.31) ], and Other [aHR 1.22( 1.12- 1.32)] racial groups had
a significantly increased hazard of death as compared to non-Hispanic
whites (Table 3). Hispanics and “Other” had a slightly increased
hazard of death than was found in the unadjusted model while
non-Hispanic blacks had a significantly decreased 10-year hazard of
death in the adjusted model as compared to the unadjusted model.
There was no statistical difference between each Yost quintile groups
and the reference group with the 10-year hazard of death for each group
being approximately the same as that of the reference group. Controlling
for all other variables decreased the hazard of death associated with
the tumor type except for anaplastic astrocytoma and glioblastoma tumor
types which still had a significantly high hazard of death [aHR,
2.13(1.83-2.48)].