Socioeconomic disparities and comorbidities, not race, affect salivary gland malignancy survival outcomes

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The Laryngoscope


OBJECTIVES/HYPOTHESIS: This study sought to determine whether comorbidities, race, and socioeconomic factors affect 5- and 10-year survival outcomes for patients with salivary gland malignancies treated at a single large academic institution with a large African American population.

STUDY DESIGN: A retrospective cohort study was performed of all patients with salivary gland malignancies, from 1990 to 2015, at a large academic medical center.

METHODS: Standard statistical analysis was performed using Kaplan-Meier survival curve analysis and Cox proportional hazard models.

RESULTS: The overall 5- and 10-year survival rates decreased with age ≥ 60 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 a ZIP code with an increasing proportion of residents with a high school degree or less (P < .05), being male (P < .05), increasing age at the time of diagnosis (P < .001), and increasing Charlson comorbidity index (P < .05) detrimentally impacted survival at 5 and 10 years. Race was associated with socioeconomic variables, but race was not a prognostic indicator of survival.

CONCLUSIONS: Socioeconomic factors and comorbidities, not race, were negative prognostic indicators of survival of patients with salivary gland malignancies. Using race as a marker for socioeconomic status should be used with caution.

LEVEL OF EVIDENCE: 4. Laryngoscope, 127:2545-2550, 2017.

Medical Subject Headings

Comorbidity; Female; Humans; Male; Middle Aged; Prognosis; Registries; Retrospective Studies; Salivary Gland Neoplasms; Socioeconomic Factors; Survival Analysis

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