Age-Stratified Survival in Adults with Nonmalignant Intracranial Meningioma: A Population-Based SEER Cohort Study

Purpose Age is a major determinant of prognosis in meningioma; however, decade-specific survival benchmarks across adulthood for nonmalignant intracranial meningioma remain poorly defined. This study evaluated age-stratified overall survival according to sex, race, ethnicity, tumor size, and surgical management in a population-based cohort. Methods A retrospective cohort study was conducted using the Surveillance, Epidemiology, and End Results (SEER) Research Plus database (2004–2022). Patients were stratified into five age groups (< 50, 50–59, 60–69, 70–79, ≥ 80 years). Kaplan–Meier analysis and log-rank testing were used to evaluate overall survival across age groups. Age-stratified Cox proportional hazards models assessed associations of sex, race, and ethnicity with mortality. Tumor size–stratified analyses compared 10-year overall survival between surgical and nonoperative cohorts. Results A total of 48,964 patients were included in this study. Female sex was associated with improved survival across all age strata, whereas Black race was associated with higher mortality among patients younger than 80 years. Hispanic ethnicity was not associated with survival differences within age strata. Surgical resection was associated with improved 10-year overall survival across most tumor sizes and age groups, with greater survival differences observed in larger tumors. Among patients aged 70–79 years with tumors < 20 mm, surgical management was not associated with a statistically significant survival difference. Conclusion Overall survival in nonmalignant intracranial meningioma varies meaningfully according to age, sex, race, tumor size, and treatment status. These findings provide age-stratified population-level survival benchmarks that may support individualized prognostic counseling and management decisions.