Associations between Age, Treatment Modality and Survival in Atypical Meningioma: Analysis of the SEER Database, 2000-2021.

Purpose: Atypical meningiomas have higher recurrence and mortality than benign variants, and age may influence treatment decisions and outcomes. We evaluated associations between age, treatment modality, and survival in patients with atypical meningioma.

Methods: Adults with histologically confirmed intracranial atypical meningioma were identified from the 2000-2021 Surveillance, Epidemiology, and End Results database. Multivariable Cox regression assessed overall survival (OS) and cancer-specific survival (CSS), and logistic regression evaluated predictors of gross total resection (GTR) versus subtotal resection (STR).

Results: Among 3,882 patients, advanced age was associated with worse OS and CSS. Compared with patients aged <40 years, those aged ≥60 years had higher overall mortality (aHR 5.29, 95% CI 3.78-7.39) and cancer-specific mortality (aHR 3.15, 95% CI 1.99-4.99; both p < 0.001). Patients aged 40-59 years showed intermediate OS risk but no significant difference in CSS. Older patients received radiotherapy less often, whereas age was not an independent predictor of GTR. STR, male sex, unmarried status, tumor ≥5 cm, and Black race were associated with poorer survival.

Conclusion: Advanced age independently predicted inferior OS and CSS but not a lower likelihood of GTR, supporting individualized, age-sensitive management.