Clinical study The epidemiology of patients undergoing meningioma resection in Auckland, New Zealand, 2002 to 2011 Clinton P. Turner a,d,⇑ , Bert van der Werf b , Andrew J.J. Law c , Arnold Bok c , Maurice A. Curtis d , Michael Dragunow e a Department of Anatomical Pathology, LabPlus, Auckland City Hospital, 2 Park Road, Grafton, Auckland, New Zealand b Department of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, 22-30 Park Road, Grafton, Auckland, New Zealand c Department of Neurosurgery, Auckland City Hospital, 2 Park Road, Grafton, Auckland, New Zealand d Centre for Brain Research, Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, University of Auckland, 85 Park Road, Grafton, Auckland, New Zealand e Centre for Brain Research, Department of Pharmacology, Faculty of Medical and Health Sciences, University of Auckland, 85 Park Road, Grafton, Auckland, New Zealand article info Article history: Received 21 December 2019 Accepted 9 June 2020 Available online xxxx Keywords: Meningioma Incidence Recurrence Ethnic groups abstract The incidence of meningioma is known to vary by gender and ethnicity. This study aimed to describe the epidemiological characteristics of a 10-year cohort of patients undergoing meningioma resection at Auckland City Hospital, Auckland, New Zealand. Of particular interest was whether there was any differ- ence in meningioma incidence and recurrence rates between New Zealand Maori and Pacific Island patients compared with other ethnic groups. The study was a retrospective analysis of 493 patients with pathologically confirmed meningioma over the period 1 January 2002 to 31 December 2011. Based on this neurosurgical cohort, the minimum incidence of meningioma in the Auckland region was 3.39 per 100,000 population per year (95% C.I. 3.02–3.80) for the study period. Meningioma was significantly more common in women than men by a ratio of 4.2:1. New Zealand Maori and Pacific Island patients had a sig- nificantly higher incidence of meningioma than other ethnic groups. New Zealand Maori had a menin- gioma incidence 2.74 times that of Europeans (95% C.I. 2.01–3.73, p < 0.001). Pacific Island patients had 2.03 times higher incidence of meningioma than Europeans (95% C.I. 1.42 – 2.89, p < 0.001). The over- all meningioma recurrence rate was 21.6% with a mean follow-up of 77 months. Recurrence rates for meningioma among Pacific Island patients were significantly higher than for other ethnic groups (hazard ratio 1.73, p = 0.008). Multivariate analysis of clinical variables confirmed the significance of traditional prognostic factors such as WHO tumour grade and Simpson grade of surgical excision in predicting meningioma recurrence. Ó 2020 Elsevier Ltd. All rights reserved. 1. Introduction Meningiomas are a group of predominantly benign, slow grow- ing tumours that are thought to derive from the meningothelial cells of the arachnoid layer [1]. They are the most common primary central nervous system (CNS) tumour, representing around 37% of all CNS tumours with an annual incidence in the United States of 8.6 per 100,000 of population [2]. Meningiomas are significantly more common in women than men and show varying incidence among different ethnic groups [2,3]. Meningiomas are currently graded on histological criteria into three groups: benign (WHO grade I), atypical (WHO grade II) and anaplastic (WHO grade III) [1]. Whilst most meningiomas do not exhibit overtly malignant behaviour; they can still cause significant morbidity and mortality through local effects in anatomically critical and/or surgically inac- cessible locations. A Dutch study found meningioma patients between the ages of 45 and 65 years have significant rates of long-term disability as well as significantly worse overall survival than age matched controls due to disease recurrence and stroke [4]. Therefore, while generally biologically benign, a diagnosis of meningioma can have significant and long-lasting effects for indi- vidual patients. Previously it has been reported that New Zealand Maori (Maori) and Polynesian patients are over-represented in patients undergo- ing meningioma resection at Auckland City Hospital [5]. However, no studies have specifically examined the incidence rates of https://doi.org/10.1016/j.jocn.2020.06.011 0967-5868/Ó 2020 Elsevier Ltd. All rights reserved. ⇑ Corresponding author at: Department of Anatomical Pathology, LabPlus, Auckland City Hospital, 2 Park Road, Grafton, Auckland, New Zealand. E-mail address: clintont@adhb.govt.nz (C.P. Turner). Journal of Clinical Neuroscience xxx (xxxx) xxx Contents lists available at ScienceDirect Journal of Clinical Neuroscience journal homepage: www.elsevier.com/locate/jocn Please cite this article as: C. P. Turner, B. van der Werf, A. J. J. Law et al., The epidemiology of patients undergoing meningioma resection in Auckland, New Zealand, 2002 to 2011, Journal of Clinical Neuroscience, https://doi.org/10.1016/j.jocn.2020.06.011