Analysis of 223 Brain Tumor Patients Treated at a Level 1 Trauma County Medical Center

Introduction: Modern brain tumor therapy requires multidisciplinary teams for effective treatment. County-directed Level 1 Trauma medical centers are specifically geared to care for acute trauma and indigent populations. In this unique study, we compare the brain tumor characteristics and follow-up data at Harbor-UCLA Medical Center.

Methods: A retrospective chart review was performed for every brain tumor treated with neurosurgery between July 2006 and December 2010. All patients had their gender, age, tumor pathology, follow-up, and outcome survivals aggregated for analysis. Inclusion criteria were: (1) follow-up data reporting survival and tumor recurrence, (2) documented brain tumor outcomes, and (3) adequate mortality follow-up data.

Results: In total, 271 patients met the inclusion criteria and had quantifiable outcome data following brain tumor treatment. The mean age at time of surgery was 46.9 years, with an average follow-up time of 1.5 ± 0.8 years. Common skull base tumors included meningiomas (22.4%), pituitary adenomas (22.4%), and acoustic neuromas (5.1%). Average Karnofsky Performance Score (KPS) was slightly improved in the immediate postoperative interval versus preoperative (71.1 vs. 68.0) assessment, but this difference was not statistically significant. A significantly greater proportion of Hispanic (11%) and African American (3.4%) brain tumor patients were treated when compared with the local population (P = 0.001, and P = 0.035, respectively).

Conclusion: Our data suggest that skull base brain tumor neurosurgery is an essential need, even at County Medical Centers targeting trauma care. Our analysis indicates that neurosurgical intervention for skull base brain tumors may be effectively and safely used with good follow-up within this population, and that ethnic disparities within this setting may be an important topic for further investigation.