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Resident PGY 4
Henry Ford Hospital
Objective: To determine whether comorbidities, socioeconomic factors, and race affect median survival times and overall survival outcomes for patients with laryngeal squamous cell carcinoma treated at a single institution with a large African American population. Study Design: Retrospective cohort study Setting: Tertiary care medical center. Subjects and Methods: Six-hundred nineteen patients treated for laryngeal squamous cell carcinoma at a single institution between 1999 and 2013. Kaplan-Meier survival curve analysis and Cox proportional hazard models were used. Results: Median survival time decreased with age ≥ 65 years (P < .001), stage 3 or 4 (P < .001),clinical T stage 3 or 4 (P < .001), and clinical N stage 1, 2, or 3 (P < .001). Living in zip code with increasing proportion of residents with high school degree or less (P < .001),increasing proportion of residents living below the poverty level (P < .001), and increasing Charlson Comorbidity Index (P < .001) were associated with increased risk of death. Increasing median household income was associated with decreased increased risk of death (P < .001). Caucasian, rather than African American, race was associated with decreased median survival time (P = .01). Conclusion: Socioeconomic factors and medical comorbidities were negative prognostic indicators of survival in patients with laryngeal squamous cell carcinoma. Contrary to previous reports, African American race was associated with improved overall survival in univariate analysis. However, once socioeconomic factors were controlled for, race conferred no effect on survival. Rather, living in neighborhoods with higher median household income was protective.
Kam, Joanna; Williams, Amy M; Van Harn, Meredith; Sanii, Ryan; and Chang, Steven S., "Socioeconomic Determinants of Survival in Laryngeal Squamous Cell Carcinoma Patients" (2019). Health Care Disparities. 1.