Survival Diffs w/Primary Malignant Brain Tumor

Original Article

Racial differences in survival after diagnosis with primary malignant brain tumor

Jill S. Barnholtz-Sloan, Ph.D. 1 2 3 *, Andrew E. Sloan, M.D. 2 3, Ann G. Schwartz, Ph.D., M.P.H. 1 3

1Department of Internal Medicine, Division of Hematology/Oncology, Wayne State University School of Medicine, Detroit, Michigan 2Department of Neurosurgery, Wayne State University School of Medicine, Detroit, Michigan 3Barbara Ann Karmanos Cancer Institute, Detroit, Michigan

email: Jill S. Barnholtz-Sloan (

*Correspondence to Jill S. Barnholtz-Sloan, Wayne State University-Karmanos Cancer Institute, 110 East Warren, Detroit, MI 48201

Fax: (313) 831-7806

Conference: American Association of Cancer Research, Washington, DC, 11 July 2003 to 14 July 2003.

Funded by: National Institutes of Health (Detroit SEER Registry); Grant Number: N01-PC-65064 National Cancer Institute; Grant Number: K07 CA91849-01 American Brain Tumor Association



Previous studies have shown that the overall incidence of primary malignant brain tumor is greatest in Caucasians, although survival is better in African Americans.

The objective of this study was to examine racial differences in survival after diagnosis with primary malignant brain tumor in a population-based sample of patients while adjusting for prognostic variables that differ by race.


The authors analyzed 21,493 patients (20,493 Caucasians and 1000 African Americans) who were diagnosed with primary malignant brain tumors from 1973 to 1997 (with follow-up through 1999) from the population-based Surveillance, Epidemiology, and End Results (SEER) Program. Chi-square tests were used to determine statistical significance of prognostic variables and race (using two-sided P values). Kaplan-Meier and Cox proportional hazards models were used to assess survival differences by race.


The univariable model for race showed no survival difference by race.

The multivariable model demonstrated that African American patients were at a 13% increased risk of death from any cause compared with Caucasian patients.

The racial difference was explained further by an interaction between race and surgery type in which there was an increased risk of death for African American patients who underwent subtotal resections or surgery not otherwise specified compared with Caucasian patients who underwent the same procedures.


There was a significant difference in the risk of death due to any cause for Caucasian patients and African American patients who were diagnosed with first primary brain tumors.

Cancer 2003;98:603-9.

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