Socioeconomic disparities and comorbidities, not race, affect salivary gland malignancy survival outcomes
Iwata AJ, Williams AM, Taylor AR, and Chang SS. Socioeconomic disparities and comorbidities, not race, affect salivary gland malignancy survival outcomes Laryngoscope 2017 Nov;127(11):2545-2550.
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