{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T01:05:52Z","timestamp":1780448752753,"version":"3.54.1"},"reference-count":44,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The aim of this study was to characterize sociodemographic disparities in long-term survival outcomes among adults and children with craniopharyngioma and evaluate their impact on surgical approach and radiation therapy (RT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Using the Surveillance, Epidemiology, and End Results database (2000\u20132022), the authors retrospectively identified adult (age \u2265 18 years) and pediatric patients with craniopharyngioma who had undergone resection. Log-rank tests and multivariable Cox proportional hazards regression were used to assess the impact of race\/ethnicity, county-level median household income, extent of resection, and RT on overall survival. Separate analyses were performed for pediatric and adult cohorts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>The cohort consisted of 3132 patients with craniopharyngioma, including 832 pediatric and 2300 adult patients. Racial disparities were identified, with non-Hispanic Black patients demonstrating 15-year survival of 39.8% in adults and 75.7% in children compared with 52.5% and 88.6% for White patients, respectively. After multivariable adjustment, Black race remained an adverse prognostic factor in both pediatric (HR 2.9, 95% CI 1.56\u20135.56, p &lt; 0.001) and adult (HR 1.67, 95% CI 1.39\u20132.15, p &lt; 0.001) cohorts. Among adults, both Hispanic (HR 0.78, 95% CI 0.62\u20130.98, p = 0.003) and Asian\/Pacific Islander (HR 0.654, 95% CI 0.472\u20130.905, p = 0.01) races were independently protective compared with White race. There were significant income-based disparities (p = 0.0029) concentrated among adults undergoing subtotal resection (STR), where lower-income patients demonstrated 15-year survival of 42.1% compared with 63.5% for higher-income patients; outcomes after gross-total resection (GTR) were comparable based on income strata (57.3% vs 57.7%, respectively). Among adults, STR with RT led to a 15-year survival of 63.7%\u2014not significantly different from GTR with RT (58.2%)\u2014whereas STR alone showed inferior outcomes (49.7%). Among pediatric patients, extent of resection did not independently predict survival, whereas RT was protective (HR 0.55, 95% CI 0.301\u20130.994, p = 0.048).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Substantial racial and socioeconomic disparities in survival persist in craniopharyngioma, even after adjusting for tumor characteristics and treatment received. Non-Hispanic Black patients in both age groups experienced inferior outcomes. Income-based disparities were concentrated among adults who had undergone conservative surgical approaches, suggesting differential access to adjuvant RT. Selection bias limited direct treatment comparisons; however, conservative resection without adjuvant RT was associated with significantly inferior outcomes. Ensuring equitable access to multimodal treatment and addressing structural barriers to specialized care may help reduce these disparities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2026.2.focus251157","type":"journal-article","created":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:01:02Z","timestamp":1779840062000},"page":"E10","source":"Crossref","is-referenced-by-count":0,"title":["Racial and socioeconomic disparities in long-term survival in craniopharyngioma: a SEER database analysis"],"prefix":"10.3171","volume":"60","author":[{"given":"Hazem S.","family":"Ghaith","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, Oregon Health & Science University, Portland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saud K.","family":"Zaidan","sequence":"additional","affiliation":[{"name":"School of Medicine, Oregon Health & Science University, Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin A.","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Oregon Health & Science University, Portland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew K.","family":"McIntyre","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Oregon Health & Science University, Portland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Gendreau","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Oregon Health & Science University, Portland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed M.","family":"Raslan","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Oregon Health & Science University, Portland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olabisi R.","family":"Sanusi","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Oregon Health & Science University, Portland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"4","key":"b1","series-title":"J Neurosurg","first-page":"547","article-title":"The descriptive epidemiology of craniopharyngioma","volume":"89","author":"Bunin GR","year":"1998","unstructured":"Bunin GR, Surawicz TS, Witman PA, Preston-Martin S, Davis F, Bruner JM. 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