Racial disparity in recommendation for surgical resection of skull base chondrosarcomas: A Surveillance, Epidemiology, and End Results (SEER) analysis

Sanjay Dhawan, Ali A. Alattar, Jiri Bartek, Jun Ma, Mohamad Bydon, Andrew S. Venteicher, Clark C. Chen

Research output: Contribution to journalArticlepeer-review

Abstract

INTRODUCTION: There is increased appreciation of racial disparities in the delivery of neurosurgical care. Here, we explore whether race influences surgical recommendations in the management of skull base chondrosarcomas.

METHODS: We identified 493 patients with skull base chondrosarcoma using the Surveillance, Epidemiology, and End Results (SEER) registry (November 2017 submission). Regression analyses were performed to identify demographic variables associated with recommendation against surgery. Univariate and multivariate cox proportional hazards models were used for survival analysis.

RESULTS: In a univariate analysis, we found that the African-American race was associated with an increased likelihood of surgeon recommendation against surgery (OR = 4.416, 95% CI = 1.893-10.302, p = 0.001). This association remained robust in the multivariate model that controlled for other covariates, including age of diagnosis (OR = 5.091, 95% CI = 2.127-12.187, p < 0.001). For patients who received a recommendation against surgery, the likelihood of dying from non-chondrosarcoma causes was comparable between Caucasian and African-American patients, suggesting that the prevalence and severity of medical conditions that increase the risk of death were comparable between these cohorts (HR = 0.466, 95% CI = 0.057-3.802, p = 0.475). The likelihood of dying from chondrosarcoma was comparable between Caucasian and African-American patients who underwent surgery (HR = 0.982, 95% CI = 0.353-2.732, p = 0.973), suggesting absence of race-specific surgical benefits.

CONCLUSION: We identified a racial disparity against African-Americans in recommendations for surgical resection of skull base chondrosarcomas.

Original languageEnglish (US)
Pages (from-to)186-191
Number of pages6
JournalJournal of Clinical Neuroscience
Volume94
DOIs
StatePublished - Dec 2021

Bibliographical note

Publisher Copyright:
© 2021

Keywords

  • Chondrosarcoma
  • Racial disparity
  • SEER
  • Surgical recommendation
  • Surveillance, Epidemiology and End Results
  • Chondrosarcoma/epidemiology
  • SEER Program
  • Humans
  • Skull Base
  • African Americans
  • Whites

PubMed: MeSH publication types

  • Journal Article

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