Influence of Recent Cancer on Treatment and Outcomes in Adults With Malignant Brain Tumors
Objective:
To examine the influence of recent or concurrent cancers on early treatment patterns and short-term outcomes in adults with malignant brain tumors (MBTs).
Background:
MBTs are among the deadliest cancers worldwide. A recent or concurrent cancer diagnosis may influence the management and prognosis of adults with MBT. Understanding how recent malignancies influence MBT treatment course and clinical trajectory may improve risk stratification and guide multidisciplinary care pathways in this population.
Design/Methods:
Using the TriNetX Research Network (2000-2025), we identified adults (age≥18) with MBT (ICD-10 C71) and compared those with a cancer diagnosis (ICD-10 C00-D49) within 1 year before MBT to those without any prior cancer history.
Propensity score matching (PSM) adjusted for demographics (age, sex, race, ethnicity, marital status) and clinical comorbidities (tobacco use, hypertension [systolic blood pressure≥130], diabetes mellitus, chronic obstructive pulmonary disease, chronic kidney disease, and depression). Hazard ratios (HRs) and 95% confidence intervals were estimated using Cox proportional-hazards models, and significant differences were assessed with log-rank testing. The proportional hazards assumption was evaluated using Schoenfeld residuals.
The SUNY Upstate Medical University Institutional Review Board approved this study for exempt status (Protocol # 2302956).
Results:
After 1:1 PSM (n=2,491), adults with MBT and recent cancer were more likely to undergo resection (HR=5.270, p<0.001) and initiate chemotherapy (HR=2.824, p<0.001) earlier after MBT diagnosis compared to those with no prior cancer history. In addition, adults with MBT and recent cancer showed elevated risks of hospitalization (HR=3.983 p<0.001), emergency department visits (HR=2.544, p<0.001), palliative care encounters (HR=2.652, p<0.001), and mortality (HR=2.139, p<0.001).
Conclusions:
Recent cancer in adults with MBT was associated with increased treatment intensity and greater risk of adverse outcomes, suggesting that recent or concurrent malignancy may influence MBT clinical course. Integration of this distinct clinical phenotype into MBT care models may improve outcomes in this high-risk population.
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