Clinical neurology and neurosurgery · 2025
Assessing disparities in surgical recommendations for adult acoustic neuroma patients: A study using the surveillance, epidemiology, and end results database.
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Reddy Sai Chandan, Li Adrian, Horowitz Melanie, Singh Arjit, Gendreau Julian L, Ahmed A Karim, Mukherjee Debraj
Аннотация
BACKGROUND AND OBJECTIVES: Acoustic neuromas are benign tumors that arise from Schwann cells of the vestibular nerve. In this study, we examined disparities in the surgical management of acoustic neuroma patients, with a focus on sociodemographic factors such as sex, race, ethnicity, and income.
METHODS: Data from the Surveillance, Epidemiology, and End Results (SEER) database was used to identify all patients > 18 years of age diagnosed with acoustic neuroma between 2000 and 2021. Univariable and multivariable logistic regressions were used to calculate odds ratios (OR) for variables linked to the likelihood of receiving a surgical recommendation and undergoing subsequent surgery.
RESULTS: We identified 8332 patients with acoustic neuroma. Of these patients, 5458 received a surgical recommendation and 2874 did not. A multivariate analysis showed that Asian/Pacific Islander race (OR: 1.62, CI: 1.16-2.24, p = 0.004), Hispanic ethnicity (OR: 1.73, CI: 1.25-2.39, p = 0.001), larger tumor size (OR: 1.08, CI: 1.07-1.09, p < 0.001), and no radiotherapy usage (OR: 1307.48, CI: 912.97-1936.71, p < 0.001) were linked to increased odds of receiving a surgical recommendation. Older age (OR: 0.96, CI: 0.96-0.97, p < 0.001) was linked to decreased odds of receiving a surgical recommendation.
CONCLUSION: Patients identifying as Asian/Pacific Islander or Hispanic were more likely to receive surgical recommendations and be treated surgically for the management of acoustic neuromas. Future studies are needed to further investigate the source of these disparities, exploring the potential role of surgeon bias and the impact of racial and ethnic identity on treatment preferences and adherence to medical directives, in an effort to promote greater health equity in acoustic neuroma patients.
METHODS: Data from the Surveillance, Epidemiology, and End Results (SEER) database was used to identify all patients > 18 years of age diagnosed with acoustic neuroma between 2000 and 2021. Univariable and multivariable logistic regressions were used to calculate odds ratios (OR) for variables linked to the likelihood of receiving a surgical recommendation and undergoing subsequent surgery.
RESULTS: We identified 8332 patients with acoustic neuroma. Of these patients, 5458 received a surgical recommendation and 2874 did not. A multivariate analysis showed that Asian/Pacific Islander race (OR: 1.62, CI: 1.16-2.24, p = 0.004), Hispanic ethnicity (OR: 1.73, CI: 1.25-2.39, p = 0.001), larger tumor size (OR: 1.08, CI: 1.07-1.09, p < 0.001), and no radiotherapy usage (OR: 1307.48, CI: 912.97-1936.71, p < 0.001) were linked to increased odds of receiving a surgical recommendation. Older age (OR: 0.96, CI: 0.96-0.97, p < 0.001) was linked to decreased odds of receiving a surgical recommendation.
CONCLUSION: Patients identifying as Asian/Pacific Islander or Hispanic were more likely to receive surgical recommendations and be treated surgically for the management of acoustic neuromas. Future studies are needed to further investigate the source of these disparities, exploring the potential role of surgeon bias and the impact of racial and ethnic identity on treatment preferences and adherence to medical directives, in an effort to promote greater health equity in acoustic neuroma patients.