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Nagasawa D, Bergsneider M, Kelly D, Shafa B, Duong D, Ausman J, Liau L, McBride D, Yang I, Mann B, Yabroff R, Harlan L, Zeruto C, Abrams J, Gondi V, Eickhoff J, Tome W, Kozak K, Mehta M, Field K, Drummond K, Yilmaz M, Gibbs P, Rosenthal M, Allaei R, Johnson K, Hooten A, Kaste E, Ross J, Largaespada D, Rice T, Zheng S, Xiao Y, Decker P, McCoy L, Smirnov I, Patoka J, Hansen H, Wiemels J, Tihan T, Prados M, Chang S, Berger M, Pico A, Rynearson A, Voss J, Caron A, Kosel M, Fridley B, Lachance D, O'Neill B, Giannini C, Wiencke J, Jenkins R, Wrensch M, Xiao Y, Decker P, Rice T, Hansen H, Wiemels J, Tihan T, Prados M, Chang S, Berger M, Kosel M, Fridley B, Lachance D, O'Neill B, Buckner J, Burch P, Thompson R, Nabors L, Olson J, Brem S, Madden M, Browning J, Wiencke J, Egan K, Jenkins R, Wrensch M, Wang M, Dignam J, Won M, Curran W, Mehta M, Gilbert M, Paker A, Chi T, Kamiya-Matsuoka C, Loghin M
Аннотация
INTRODUCTION: Precise and effective treatment for brain tumors requires multidisciplinary teams with advanced technology. The Harbor-UCLA Medical Center is a 570-bed academic medical center owned by the county of Los Angeles. Here we analyze the role of a county academic neurosurgery service in treating the brain tumors of the local population. METHODS: A retrospective chart review was performed for every patient who had received neurosurgical care at the medical center for a brain tumor between July 2006 and December 2010. Demographic characteristics, follow-up information, and outcome survival of all patients were aggregated for analysis. RESULTS: A total of 271 patients underwent a neurosurgical procedure for an intracranial tumor during this 4.5-year interval. The tumor distribution was as follows (pathologic information was unavailable for 16 patients): 58 gliomas (22.7%), 57 meningiomas (22.4%), 57 pituitary adenomas (22.4%), 27 metastatic tumors (10.6%), 13 acoustic neuromas (5.1%), 7 craniopharyngiomas (2.7%), and 36 other tumors (14.1%). The mean age at surgery was 46.9 years and the male-to-female ratio was 47:53. A significantly higher proportion of the treated patients than the Los Angeles county population was Hispanic (56% vs. 45%, p < 0.001) or African American (12.9% vs. 9.5%, p = 0.035), and a significantly lower proportion was Caucasian (12.2% vs. 31.1%, p< 0.001); for Asians the proportion of the treated patients was similar to that of the county population (12.2% vs. 11.8%). CONCLUSION: Our data suggest that compared with the overall Los Angeles county population, a high percentage of Hispanics and African Americans receive neurosurgical treatment at Harbor-UCLA for brain tumors. This discrepancy may highlight important socioeconomic and cultural factors which may affect neurosurgery care for brain tumors at county academic facilities, and it identifies opportunities to improve the delivery of health care and neurosurgery.