The Impact of Race and Socioeconomic Status on Mortality in Pediatric Patients with Central Nervous System Tumors at a Single, Tertiary Care Institution

BACKGROUND In pediatric patients with central nervous system (CNS) tumors, survival is associated with World Heatlh Organization (WHO) grade and location but the impact of social determinants of health is less clear. Many publications utilize the Surveillance, Epidemiology, and End Results (SEER) databases to assess social determinants of health. While this is a comprehensive resource, there is a paucity of data from geographic regions, like Ohio. PROCEDURE The relationships between race and socioeconomic status (SES) on the 5-year overall survival (OS) and event free survival (EFS) of pediatric patients with primary CNS tumors treated at a single, tertiary institution from 2009-2017 (n=184) were analyzed. Race and SES were determined through self-designation and an index-based county economic classification system respectively. Kaplan-Meier Survival Analyses were performed for OS and EFS. Cox Proportional Hazards models evaluated the association of race, SES, WHO tumor classification and grade, and tumor location, both individually and in combination, with OS and EFS. RESULTS Grade and location of tumor impacted OS and EFS with high-grade tumors yielding worse outcomes (p-values 0.2). Comparison of models showed OS and EFS were not impacted by race or SES, but rather a combination of tumor classification, grade, and location. CONCLUSION There was no association between race or SES on outcomes in our population at a single, tertiary institution, which deviates from previous data.