Analytical Insights into the Epidemiology of Glioma and Treatment Modalities.
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BACKGROUND: Glioma is a common malignant intracranial tumor. This study investigated different treatment strategies and multiple epidemiological characteristics-including age, sex, ethnicity, and income-on the risk of developing glioblastoma and patient survival outcomes. METHODS: We obtained data from 44,778 patients treated for gliomas (1980-2019) from the Surveillance, Epidemiology, and End Results database. The survival curve was plotted using the Kaplan-Meier method, and Cox regression analysis was employed for prognostic factor analysis. RESULTS: This study analyzed the incidence and survival trends of glioma based on population data from the Surveillance, Epidemiology, and End Results database. The overall incidence rate exhibited a downward trend, with a higher incidence rate among Whites, men, and people aged >60 years. The survival rate of each subgroup gradually increased. Surgical treatment yields the best survival rates in grade 1-2 gliomas. In grade 3-4 gliomas, survival outcomes are better when treated with surgery, followed by chemotherapy. Cox regression analysis of the prognosis of patients undergoing postoperative radiotherapy revealed that chemotherapy (hazard ratio [HR], 0.386; 95% confidence interval [CI], 0.272-0.549) and isocitrate dehydrogenase mutations (HR, 0.181; 95% CI, 0.097-0.335) were protective factors, whereas grade 3-4 tumors (HR, 2.179; 95% CI, 1.303-3.645) and age ≥50 years (HR, 1.746; 95% CI, 1.239-2.461) were risk factors. For patients with isocitrate dehydrogenase mutations and/or 1p/19q codeletion, surgery combined with chemoradiotherapy offers the best therapeutic efficacy. CONCLUSIONS: These findings reveal the dynamic changes in the incidence pattern of glioma, the continuous improvement in survival rates, and the prognostic value of molecular characteristics and socioeconomic factors, deepening the understanding of the effects of different treatment modalities and providing a basis for clinical diagnosis and treatment strategies.