We analyzed the National Cancer Database (NCDB) from 2004-2014 for all patients with diagnosis of primary brain and CNS tumors. NCDB collects long-term survival data for over 70% of all newly diagnosed cancers.

464,852 patient tumor records were identified. The most common histology was meningioma (43.4%), followed by glioblastoma (21.9%), and nerve sheath tumors (10.6%). Median age was 60 years, with a female (57.9%), white (85.2%), and non-Hispanic (87.5%) predominance. WHO grade I accounted for 43.7% of the patients, grade II for 6.5%, grade III 4.5%, grade IV for 23.8%, WHO grade unknown for 7.9%, and the remaining 13.7% included histology groups where WHO grade is not used. Overall, 56% underwent surgical procedures, 30.4% received radiation, and 20.5% received chemotherapy. Radiation, plus chemotherapy and surgery was the most common treatment modality in high-grade tumors (47.6%), while surgery only (42.7%) or watchful waiting (41.4%) was preferred in low-grade tumors. Median survival was 9 years for all primary brain tumors, but varied significantly by histology group. Median survival was 13 years for grade I tumors, 12 years in grade II, 3 years in grade III, and 10 months in grade IV. Older age, male gender, white race, higher number of comorbidities, and lower socioeconomic status were identified as risk factors for mortality.

We provide the largest investigation of primary brain tumors with similar outcomes to those reported for population-based datasets. Our analysis provides benchmark survival estimates and treatment outcomes throughout the United States with significant opportunity for improvement.