Tumor behavior disparities in all-cause and cause-specific mortality among patients with central nervous system tumors

The tumor behavior disparities (nonmalignant vs. malignant) in all-cause and cause-specific mortality among patients with central nervous system (CNS) tumors have not been investigated. In this study, a total of 324,817 US patients with CNS tumors (including 207,273 nonmalignant tumors and 117,544 malignant tumors) were enrolled from the SEER database (SEER-17; 2000-2021). Among all patients, 23.70% died from primary tumors, and 18.52% died from competing risk events. Among all competing event deaths, cardiovascular disease (CVD) death (27.32%) was the most common cause of death. Compared with patients with nonmalignant tumors, patients with malignant tumors had a significantly greater proportion of all-cause deaths (70.73% vs. 26.05%) and primary tumor deaths (61.48% vs. 2.28%), whereas they had a lower proportion of competing event deaths (9.25% vs. 23.77%). Among patients with nonmalignant tumors, all-cause deaths were attributed mainly to competitive risk deaths. In contrast, all-cause deaths were attributed mainly to primary tumor deaths among patients with malignant tumors. The patients with malignant tumors had higher risks of all-cause mortality (HR = 5.4, 95% CI: 5.32-5.48, P < 0.001), primary tumor mortality (HR = 47.3, 95% CI: 45.8-48.9, P < 0.001), and competing event mortality (HR = 1.05, 95% CI: 1.02-1.08, P < 0.001) compared to those with non-malignant tumors, respectively. The all-cause and cause-specific mortality for causes of death (COD) varied by tumor behavior and tumor type. This study investigated the tumor behavior disparities in all-cause and cause-specific mortality via a larger population-based cohort, and it provided robust evidence for an in-depth understanding of the tumor behavior disparities in cumulative mortality among patients with CNS tumors.