1029 Facility Volume Status is Predictive of Survival in Patients With Intracranial Meningioma: 15-Year Analysis of the National Cancer Database

INTRODUCTION: Emerging evidence suggests that patients diagnosed with brain neoplasms might experience better outcomes when receiving treatment at high-volume facilities (HVFs) compared to low-volume facilities (LVFs). The sociodemographic factors influencing the choice of treatment center, however, remain unclear. METHODS: The National Cancer Database (NCDB) was queried for adults treated for intracranial meningioma. HVFs (top 15%) were facilities performing >45 meningioma procedures/year. Mann-Whitney U and Chi-squared tests were performed for bivariable analysis of continuous and categorical variables, respectively. Multivariable logistic and linear regressions assessed whether demographic variables predicted treatment at HVFs. A multivariable Cox proportional hazards model determined association between volume and overall survival (OS). RESULTS: Our study encompassed 181,461 patients, with 28,325 (15.6%) treated at HVFs and 153,076 (84.4%) at LVFs. Privately insured patients were more likely to receive treatment at HVFs (p < 0.001). Patients treated at LVFs tended to be older (p < 0.001) and present with larger tumors (p < 0.001). Treatment at an HVF was associated with improved survival outcomes (HR = 0.62, 95% CI 0.55 – 0.70, p < 0.001). Controlling for relevant demographic and clinical variables, patients treated at HVFs were significantly more likely to undergo surgery (OR = 1.43, 95% CI 1.38 - 1.47, p < 0.001) and radiotherapy (OR = 1.5, 95% CI 0.79 - 0.94, p < 0.001), while also experiencing reduced readmission likelihood within 30 days (OR = 0.86, 95% CI 0.79 - 0.94, p < 0.01). CONCLUSIONS: Although the majority of meningioma cases are treated at LVFs, our findings suggest that patients treated at HVFs may benefit from improved survival rates compared to those treated at LVFs and are more likely to receive surgical and radiotherapeutic interventions.