Astrocytoma survival patterns and key prognostic factors: A population-based study.

Abstract

e14026 Background: Astrocytoma is a glioma that arises from astrocytes in the central nervous system and is classified into four grades (I-IV) based on malignancy. Grade IV astrocytoma, or glioblastoma, is highly aggressive and remains challenging to treat despite advancements in surgery, radiation, and chemotherapy. Methods: Data from the Surveillance, Epidemiology, and End Results (SEER) database were analyzed for astrocytoma cases (code 9400/3) diagnosed between 2000 and 2021. Extracted variables included age, sex, region, race, survival months, chemotherapy use, and vital status. Overall survival (OS) was assessed using Kaplan-Meier estimates, and Cox regression models were applied to identify prognostic factors, with statistical significance set at p < 0.05. Analyses were conducted using R software with relevant statistical packages. Results: The study included 6,671 patients, primarily young (53.2%), male (55.9%), White (69.7%), and from metropolitan areas (88.2%). Chemotherapy was not administered to 65.9% of patients. Younger patients had better five-year survival (75.6%) compared to middle-aged (36.5%) and older patients (10.3%). Females showed longer median survival (78 months) than males (62 months, p = 0.006), with higher five-year survival rates (54.3% vs. 50.4%). Survival was longer for Hispanics (median: 112 months) and Black patients (median: 100 months) compared to Whites (median: 60 months, p < 0.001). Metropolitan residents had a longer median survival (71 months) than non-metropolitan residents (43 months, p < 0.001). Chemotherapy was linked to shorter survival, with a median survival of 39 months in treated patients compared to 93 months in untreated ones (p < 0.001).Multivariate Cox regression identified older age [middle-aged: HR 2.92 (2.68–3.18), p < 0.001; older: HR 7.41 (6.73–8.17), p < 0.001], non-metropolitan residence [HR 1.13 (1.01–1.26), p = 0.027], and chemotherapy [HR 1.70 (1.58–1.84), p < 0.001] as predictors of higher mortality. Female sex was associated with a lower risk of mortality [HR 0.88 (0.82–0.95), p = 0.001]. Conclusions: Significant disparities exist in astrocytoma survival based on age, sex, and geographic location. Younger age, female sex, and metropolitan residence were linked to better outcomes, whereas older age, chemotherapy, and non-metropolitan residence were associated with increased mortality. Addressing these disparities, particularly in older and rural populations, is crucial for improving survival outcomes.