Do geographic differences or socioeconomic disparities affect survival in sinonasal squamous cell carcinoma?

Zhou, Albert H.; Chung, Sei Y.; Patel, Varesh R.; Unsal, Aykut A.; Hsueh, Wayne D.; Baredes, Soly; Eloy, Jean Anderson

doi:10.1002/alr.22029

Cited by 12 publications

(19 citation statements)

References 26 publications

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“…Sinonasal cancers are rare, comprising only 5% of head and neck cancers. They arise from the sinonasal surface epithelium and are most commonly squamous cell carcinoma (SCCA) (50%–60%) . They occur in the nasal cavity most frequently and least frequently in the frontal sinus .…”

Section: Introductionmentioning

confidence: 99%

“…They occur in the nasal cavity most frequently and least frequently in the frontal sinus . Risk factors include age, race, alcohol and tobacco use, environmental exposures, and human papillomavirus infection . These cancers affect white patients more commonly and occur twice as frequently in men rather than women .…”

Section: Introductionmentioning

confidence: 99%

“…The gold standard for treatment involves surgical resection with adjuvant radiotherapy. If total resection is limited by proximity to the orbit and skull base, chemotherapy is often used . Prior studies have shown, however, that outcomes in head and neck cancers as a whole are effected not only by treatment, but also by other factors such as age, race, socioeconomic status (SES), alcohol and tobacco use, stage of disease, and anatomic site of origin …”

Section: Introductionmentioning

confidence: 99%

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Education and insurance status: Impact on treatment and survival of sinonasal cancer patients

2019

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Objectives/Hypothesis To understand the impact of education and insurance as social determinants of health on sinonasal cancer treatment and outcomes. Study Design Retrospective cohort study using the Surveillance, Epidemiology, and End Results (SEER) database. Methods Demographics, tumor characteristics, location, stage at diagnosis, treatment, and survival data for 1,365 patients diagnosed with sinonasal cancers were extracted from the SEER database. All statistical analyses were performed using SAS 9.5. The Fine and Grey method was used to assess covariate impacts. Results Medicaid patients were more likely to live in counties with lower educational levels (8.32% vs. 6.46% below ninth grade education, P < .0001) and lower median household incomes ($56,316 vs. $60,284, P = .0004). Medicaid patients presented with later (T3‐T4) stage disease compared to other insurances (P = .0007) and larger tumor size (P = .011). Medicaid patients were less likely to have surgery recommended (P = .0017) or receive surgery as part of their treatment (P = .0033). Analysis of histology‐specific 5‐year survival rates were lower for Medicaid patients with squamous cell carcinoma (SCCA) (P = .016). Conclusions This is the first and largest study to examine how education and insurance status may impact treatment and outcomes in sinonasal cancers. It is the first using this method of examining other covariates and informing associated risk. Patients with Medicaid and less education present with larger sinonasal cancers. They are less likely to have surgery recommended or receive surgery. For SCCA, the most common histology, Medicaid patients have significantly worse survival. Further emphasis on education and improving health literacy is needed in the at‐risk Medicaid populations. Level of Evidence NA Laryngoscope, 130:649–658, 2020

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Education and insurance status: Impact on treatment and survival of sinonasal cancer patients

2019

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“…A prior city‐based imaging use analysis found the highest rates of PET use in the South (Atlanta, Georgia) and the lowest in the West (Seattle, Washington) . However, it does fit the increased rates of use demonstrated in the Western region on multiple prior SEER‐based studies . This difference in use did not result in significant differences in OS or CSS between the regions, although the West did have the highest CSS of the 4 regions.…”

Section: Discussionmentioning

confidence: 89%

“…31 However, it does fit the increased rates of use demonstrated in the Western region on multiple prior SEER-based studies. [32][33][34] This difference in use did not result in significant differences in OS or CSS between the regions, although the West did have the highest CSS of the 4 regions. Although these differences may be due Cancer August 15, 2019 to practice patterns, training experiences, or patient preference, further study is warranted to explore the potential causes as to why such significant differences exist with regard to rates of imaging use.…”

Section: Impact Of Pet Vs Mri Odds Ratio and 95% CLmentioning

confidence: 89%

Imaging at diagnosis impacts cancer‐specific survival among patients with cancer of the oropharynx

Morgan

Eguchi

Mueller

et al. 2019

Cancer

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Background The optimal imaging for the staging of oropharyngeal cancer is not well defined. Methods The linked Surveillance, Epidemiology, and End Results (SEER)–Medicare database for 2006 through 2011 was used to compare patient characteristics and hospital region by the initial imaging modality used for patients with oropharyngeal cancer. The primary outcome was 3‐year cancer‐specific survival (CSS). Cox proportional hazards models were adjusted for imaging, age, sex, region, education, race, American Joint Committee on Cancer stage of disease, and treatment, which were examined using backward elimination. The authors also explored how initial imaging use varied by patient characteristics and hospital region. Results A total of 1765 patients underwent initial diagnostic imaging. Of those, approximately 11.4% (202 patients) received computed tomography (CT) alone as their initial imaging modality, 5.2% (91 patients) underwent magnetic resonance imaging (MRI) without positron emission tomography (PET), and 83.3% (1472 patients) had initial imaging that included PET. The overall 3‐year CSS rate for the entire population was 63.7%. In the adjusted survival models compared by initial imaging modality, patients who underwent a PET examination were found to have higher survival than those who underwent CT alone or MRI, respectively (hazard ratio, 1.337 [95% CI, 1.001‐1.785; P = .0491]; and hazard ratio, 1.748 [95% CI, 1.2‐2.545; P = .0036]). Conclusions Among patients with oropharyngeal cancer, initial staging with PET imaging was associated with improved 3‐year CSS compared with initial staging with MRI or CT.

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Outcomes in chronic rhinosinusitis

Kennedy¹

2017

Int Forum Allergy Rhinol

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Do geographic differences or socioeconomic disparities affect survival in sinonasal squamous cell carcinoma?

Cited by 12 publications

References 26 publications

Education and insurance status: Impact on treatment and survival of sinonasal cancer patients

Education and insurance status: Impact on treatment and survival of sinonasal cancer patients

Imaging at diagnosis impacts cancer‐specific survival among patients with cancer of the oropharynx

Outcomes in chronic rhinosinusitis

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