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Scientific Oral Presentations

Laryngology/Broncho-Esophagology

Session: Scientific Oral Presentations 4 - Laryngology/Broncho-Esophagology

Racial Disparities in Advanced Laryngeal Squamous Cell Carcinoma: A National Cancer Database Analysis

Tuesday, October 1, 2024
10:12 AM – 10:18 AM EDT
Location: MBCC, 224
Disclosure(s):
Nihar Rama, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Samuel Robert Auger, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Danielle D. Gaskin, MSPH:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Christopher R. Roxbury, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Brandon J. Baird, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Racial and ethnic disparities in overall survival (OS) of laryngeal squamous cell carcinomas (LSCC) have recently been identified. In this study, we provide an updated database evaluation of factors contributing to racial disparities in overall survival for advanced LSCC.

Methods: Retrospective cohort study of patients with AJCC stage III or IV LSCC between 2004 and 2020 using the National Cancer Database (NCDB). Patients with missing staging or survival data were excluded. Chi square tests and multivariable Cox regressions were employed.

Results: For 49,561 patients with stage III or IV LSCC, mean age was 62.7 (SD 10.6) years; 37,495 (75.7%) were male; 39771 (80.2%) were White, and 8,250 (16.6%) were Black. The most common treatment was definitive chemoradiotherapy in 12,922 (65.6%) White patients and 2,512 (62.6%) Black patients. Surgery with adjuvant radiotherapy or chemoradiotherapy was used to treat 3,135 (15.9%) and 3,631 (18.4%) White patients compared to 726 (18.1%) and 776 (19.3%) Black patients, respectively. Total laryngectomy was performed in 10,364 (21%) patients compared to 4,079 (8.1%) patients receiving subtotal laryngectomy. Compared to Black patients, White patients were more likely to have private insurance, live in urban & affluent areas, have T1 or T2 disease, be treated at a Comprehensive Community Cancer Program, and live more than 12.5 miles from the treatment facility. There were no racial disparities in Charlson comorbidity score, time from diagnosis to surgery, or receipt of total laryngectomy versus subtotal laryngectomy. Multivariable Cox regression demonstrated that higher age, male gender, receiving care at a non-academic medical center, living in a zip code with median income greater than $46,000, Charlson comorbidity index of 1 or more, government-sponsored insurance, T stage greater than T1, nodal disease, high tumor grade, and receipt of subtotal laryngectomy instead of total laryngectomy were associated with poorer OS.

Conclusions: Racial disparities in OS of advanced LSCC are incompletely explained by differences in sociodemographic factors between White and Black patients.

    Presenting Author(s)

  • Nihar Rama, BS

    Medical Student
    University of Chicago Pritzker School of Medicine
    Mason, OH, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • Samuel R. Auger, MD

    Otolaryngology Resident - PGY-5
    Section of Otolaryngology, Department of Surgery, University of Chicago
    Chicago, Illinois, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Danielle D. Gaskin, MSPH

    Medical Student
    Pritzker School of Medicine, University of Chicago
    Chicago, IL, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • CR

    Christopher R. Roxbury, MD

    Associate Professor
    University of Chicago Medicine
    Cleveland, OH, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Senior Author(s)

  • Brandon J. Baird, MD

    Assistant Professor
    Section of Otolaryngology-Head & Neck Surgery, The University of Chicago
    Chicago, IL, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.