title: Effects of sex on the incidence and prognosis of spinal meningiomas: a Surveillance, Epidemiology, and End Results study.
abstract: OBJECTIVE
  Most spinal meningiomas are intradural lesions in the thoracic spine that present with both local pain and myelopathy. By using the large prospective Surveillance, Epidemiology, and End Results (SEER) database, the authors studied the incidence of spinal meningiomas and examined demographic and treatment factors predictive of death.
  
  
  METHODS
  Using SEER*Stat software, the authors queried the SEER database for cases of spinal meningioma between 2000 and 2010. From the results, tumor incidence and demographic statistics were computed; incidence was analyzed as a function of tumor location, pathology, age, sex, and malignancy code. Survival was analyzed by using a Cox proportional hazards ratio in SPSS for age, sex, marital status, primary site, size quartile, treatment modality, and malignancy code. In this analysis, significance was set at a p value of 0.05.
  
  
  RESULTS
  The 1709 spinal meningiomas reported in the SEER database represented 30.7% of all primary intradural spinal tumors and 7.9% of all meningiomas. These meningiomas occurred at an age-adjusted incidence of 0.193 (95% CI 0.183-0.202) per 100,000 population and were closely related to sex (337 [19.7%] male patients and 1372 [80.3%] female patients). The Cox hazard function for mortality in males was higher (2.4 [95% CI1.7-3.5]) and statistically significant, despite the lower lesion incidence in males. All-cause survival was lowest in patients older than 80 years. Primary site and treatment modality were not significant predictors of mortality.
  
  
  CONCLUSIONS
  Spinal meningiomas represent a significant fraction of all primary intradural spinal tumors and of all meningiomas. The results of this study establish the association of lesion incidence and survival with sex, with a less frequent incidence in but greater mortality among males.
authors.affiliation: Department of Surgery, Division of Neurosurgery, Centre Hospitalier de I'Université de Montréal, Hôpital Notre-Dame, Montreal, Quebec;
authors.forename: Harrison J
authors.initials: HJ
authors.lastname: Westwick
authors.affiliation: Toronto Western Hospital, Division of Neurosurgery; and.|Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Mohammed F
authors.initials: MF
authors.lastname: Shamji
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008579:Meningioma / Q000453:epidemiology* / Q000473:pathology; D008875:Middle Aged; D011379:Prognosis; D018426:SEER Program; D012737:Sex Factors; D013120:Spinal Cord Neoplasms / Q000453:epidemiology* / Q000473:pathology; D055815:Young Adult
keywords: SEER; SEER = Surveillance, Epidemiology and End Results; incidence; oncology; radiation; spinal meningioma; surgery