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Determinants of racial differences in survival for sinonasal cancer
Author(s) -
Patel Zara M.,
Li Juan,
Chen Amy Y.,
Ward Kevin C.
Publication year - 2016
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.25897
Subject(s) - medicine , multivariate analysis , proportional hazards model , demography , epidemiology , cancer , survival analysis , surveillance, epidemiology, and end results , stage (stratigraphy) , multivariate statistics , oncology , gerontology , cancer registry , statistics , paleontology , mathematics , sociology , biology
Objectives/Hypothesis Racial differences in survival are present across multiple cancer types, including sinonasal cancer. Thus far in the literature, reasons for this have been theorized but not proven. We aimed to examine proposed potential factors and understand the true determinants in racial differences for survival in sinonasal cancer. Study Design Utilizing the U.S. National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER)‐Medicare database (2000–2008), we analyzed multiple demographic, tumor‐related, and treatment‐related factors. Use of the Medicare subset allows much deeper examination of patient and treatment factors than the usual SEER database study. Methods Univariate analysis and multivariate Cox proportional hazard regression models were used. Results Eight hundred and forty‐five patients remained after exclusion criteria. Five‐year cause‐specific survival (CSS) was 62%, with a racial difference confirmed because non‐Hispanic whites (NHW) and blacks and Hispanic whites (B/HW) demonstrated 64% and 52% CSS, respectively. After multivariate analysis, factors significantly determining racial survival were age, stage, histology, grade, comorbidity status, and standard of care. Conclusion This study confirms the difference in racial survival in sinonasal cancer. In opposition to popular theories of access to care and education level‐ and poverty level‐determining outcomes, those factors were not significant on multivariate analysis, whereas stage and receiving standard of care, determined by unimodality versus multimodality treatment appropriate to stage, were the two most important prognostic factors. Level of Evidence 2c. Laryngoscope , 126:2022–2028, 2016