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Disparities in sinonasal squamous cell carcinoma short- and long-term outcomes: Analysis from the national cancer database.
- Source :
- Laryngoscope; Mar2018, Vol. 128 Issue 3, p560-567, 8p
- Publication Year :
- 2018
-
Abstract
- <bold>Objectives/hypothesis: </bold>To examine sociodemographic, hospital-specific, and disease-related characteristics in relation to outcomes in sinonasal squamous cell carcinoma (SCC).<bold>Study Design: </bold>The National Cancer Database was queried for location codes corresponding to the nasal cavity and paranasal sinuses and histology codes representing SCC malignancy. Multivariate analyses were performed against short- and long-term outcomes (overall survival, days to discharge, 30-day readmission, and 30- and 90-day mortality).<bold>Results: </bold>The database included 5,584 sinonasal SCC patients with an overall median survival of 53.5 months (95% confidence interval [CI]: 49.7-57.8). On multivariate analysis, uninsured, Medicaid, and Medicare were independently associated with worse overall survival compared to private insurance (hazard ratio [HR]: 1.49, 95% CI: 1.22-1.82, P < .001; HR: 1.57, 95% CI: 1.34-1.85, P < .001; and HR: 1.14, 95% CI: 1.01-1.29, P = .03, respectively). Both Medicaid and Medicare were also associated with increased 30-day mortality (HR: 1.36, 95% CI: 1.76-143.29, P = .02; HR: 8.27, 95% CI: 1.66-70.88, P = .02, respectively), and Medicaid patients spent more time in the hospital following surgery (difference in days to discharge: HR: 2.09, 95% CI: 0.57-3.61, P < .01). Compared to white race, other race was associated with improved overall survival (HR: 0.79, 95% CI: 0.63-0.99, P = .04) but increased 30-day readmissions (HR: 3.85, 95% CI: 1.58-8.38, P < .01). Hispanic ethnicity was associated with increased 30-day readmissions (HR: 2.35, 95% CI: 1.08-4.75, P = .02]. The highest income bracket (≥$63,000) was associated with fewer hospital readmissions (HR: 0.33, 95% CI: 0.13-0.79, P = .01).<bold>Conclusions: </bold>Sociodemographic and economic differences in outcomes of patients with sinonasal SCC cancer exist. An understanding of these differences may help minimize disparities in oncologic treatment.<bold>Level Of Evidence: </bold>2c. Laryngoscope, 128:560-567, 2018. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 0023852X
- Volume :
- 128
- Issue :
- 3
- Database :
- Complementary Index
- Journal :
- Laryngoscope
- Publication Type :
- Academic Journal
- Accession number :
- 128032395
- Full Text :
- https://doi.org/10.1002/lary.26804