American Head & Neck Society
Translational Research Meeting

April 21-22, 2015

AHNS Annual Meeting
April 22-23, 2015 during the
Combined Otolaryngology Spring Meetings

Tips on Using this Site
Locate an abstract by entering any author's surname into the search box. You may also search by keyword or program ID number.

Broaden your search by typing only a few letters of a keyword; however, do not append the wildcard “*” to a search string.

Type too small? In most browsers, press Control “+” to enlarge type size. Reset by pressing Control “0”.

Results. To view an abstract, click on a title within results. Presenters’ names are underlined among the list of authors.
Sociodemographic Disparities In Choice Of Therapy And Survival In Advanced Stage Laryngeal Cancer

Presentation: S001
Topic: Decisions in Advanced Head and Neck Cancer
Type: COSM
Date: Wednesday, April 22, 2015
Session: 9:00 AM - 9:45 AM Scientific Session #1
Authors: Alok T Saini, MD, Eric Genden, MD, MBA, Uchechukwu Megwalu, MD, MPH
atarax constipation atarax vanedannende atarax with alcohol
imipramin rezeptfrei imipramin cancer imipramin lek
Institution(s): Mount Sinai Hospital
imolope amning graviditetogvit.site imolope orifarm
mometason dosering mometason gravid mometason rezeptfrei

Importance: Identifying sociodemographic factors impacting choice of therapy and survival will reveal potential opportunities for intervention aimed at reducing health disparities.


Objective: To determine if sociodemographic factors affect choice of treatment and survival in patients with advanced stage laryngeal cancer in the U.S. using a large population-based cancer database.


Design/Setting/Participants: Population-based, non-concurrent cohort study of 5,381 patients with a diagnosis of stage III or stage IV laryngeal squamous cell carcinoma between 1992 and 2009. Data was extracted from the Surveillance, Epidemiology, and End Results (SEER) Database.


Interventions: N/A


Main Outcome(s) and Measures: Choice of therapy (surgical vs. non-surgical) and disease specific survival (DSS)


Results: On multivariable analysis, age ≥60 years (Odds Ratio [OR]=0.78; 95% CI, 0.70-0.88), stage III disease (OR=0.43; 95% CI, 0.39-0.49) and more recent year of diagnosis (OR=0.89; 95% CI, 0.87-0.90) decreased the odds of receiving surgical therapy, while residing in a county with low median household income (OR=1.36; 95% CI, 1.17-1.57) and glottic subsite (OR=1.59; 95% CI, 1.39-1.81) increased the odds of receiving surgical therapy. Age ≥60 years (Hazard Ratio [HR]=1.45; 95% CI, 1.33-1.59), black race (HR=1.14; 95% CI, 1.02-1.27), and nonsurgical therapy (HR=1.39; 95% CI, 1.26-1.52) negatively impacted DSS while female sex (HR=0.81; 95% CI, 0.72-0.90), married status (HR=0.69; 95% CI, 0.63-0.75), stage III disease (HR=0.60; 95% CI, 0.54-0.66), and glottic subsite (HR=0.81; 95% CI, 0.72-0.90) positively impacted DSS. When stratifying by treatment type, black race was a poor prognostic factor with surgical therapy (HR=1.21; 95% CI, 1.03-1.41) but not with nonsurgical therapy (HR=1.09; 95% CI, 0.94-1.27).


Conclusions and Relevance: For patients with advanced laryngeal cancer, younger age, stage IV disease, glottic cancer, and residing in a low income county increase the likelihood of receiving surgical therapy. Female sex, married status, stage III disease, and glottic subsite provides a survival benefit regardless of treatment choice. Black race appears to be a negative prognostic factor for patients treated with surgical therapy, but not with non-surgical therapy. This highlights the impact of sociodemographic factors on treatment strategies and outcomes, and highlights areas for further research on health disparities.

lansoprazol 30 mg dosis lansoprazol sandoz lansoprazol stada 15 mg

JAMA Network Logo