Skip to main content
AAO-HNSF 2024 Annual Meeting & OTO EXPO Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Back

Scientific Oral Presentations

Head and Neck Surgery

Session: Scientific Oral Presentations 5 - Head and Neck Surgery

Impact of Disparities on Functional and Clinical Outcomes in Patients With Laryngeal Squamous Cell Carcinoma

Monday, September 30, 2024
1:00 PM – 1:06 PM EDT
Location: MBCC, 208
Disclosure(s):
Natalie A. Dorin, BS:

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

Hunter H. Johnson, BS:

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

Nicolaus D. Knight, MS:

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

Panuganti A. Bharat, MD:

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

Susan D. McCammon, MD, PhD:

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

Benjamin J. Greene, MD:

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

Introduction: Social determinants of health (SDOH) have been hypothesized to impact disease outcomes. We aim to determine if SDOH affects disease and functional outcomes after treatment of laryngeal squamous cell carcinoma (SCC).

Methods: A single institution, retrospective cohort study including 759 patients with laryngeal SCC treated with surgery or chemoradiation (2011-2021). SDOH include race, insurance, and state area deprivation index (ADI), a measure of socioeconomic status. A higher ADI represents lower resources. Disease outcomes include recurrence, persistence, overall survival, primary treatment, tumor stage, and pharyngocutaneous fistula. Functional outcomes include aphonia, primary tracheoesophageal puncture (TEP), mode of communication, and return to work. Multivariate logistic regression analysis was used.

Results: The laryngeal SCC study population (n = 759) was 79% male (n = 600), 74% White (n = 562), 21.3% Black (n = 162) with a mean age of 66.05 (SD ± 10.3). 219 patients had private insurance (29%), 445 had Medicare/Medicaid (58%), and 83 had no insurance (11%). Mean ADI was 5.6 (SD ± 2.7) with a range of 1-10. Measures of SDOH did not predict tumor stage, persistence, recurrence or overall survival regardless of treatment. Patients with no insurance and increased ADI were more likely to have laryngectomy (OR 1.74, 95% CI:1.02, 3.05, p = 0.046 and OR 1.07, CI: 1.008, 1.14, p = 0.028 respectively). SDOH were not predictive of fistula. Patients with increased ADI and no insurance were more likely to be aphonic (OR 1.08, 95% CI: 1.01, 1.14, p = 0.02 and OR 2.03, 95% CI: 1.18, 3.54, p = 0.046 respectively). In patients with a laryngectomy, SDOH did not predict the primary mode of communication (i.e. writing, mouthing words, TEP, or electrolarynx) or return to work after treatment.

Conclusions: SDOH are measurable within a surgical population and can impact treatment outcomes. As ADI increases and patients have less resources, patients are more likely to receive laryngectomy and are more likely to be aphonic after laryngectomy.

    Presenting Author(s)

  • Natalie A. Dorin, BS

    Medical Student
    Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL
    Athens, AL, United States

    Disclosure(s):

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

    • Co-Author(s)

  • BT

    Bradley T. Thigpen, BS

    Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States

    Disclosure information not submitted.

  • MB

    Madeline P. Bald, BS

    Medical Student
    Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL
    Homewood, AL, United States

    Disclosure information not submitted.

  • HJ

    Hunter H. Johnson, BS

    Medical Student
    Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL
    Huntsville , AL, United States

    Disclosure(s):

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

  • NK

    Nicolaus D. Knight, MS

    Clinical Data Specialist
    Department of Otolaryngology - Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, AL
    Pinson, AL, United States

    Disclosure(s):

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

  • LB

    Luke Bailey, MD

    Department of Otolaryngology - Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, AL, United States

    Disclosure information not submitted.

  • JS

    James Stewart, MD

    Department of Otolaryngology - Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, AL, United States

    Disclosure information not submitted.

  • Andrew R. Fuson, MD

    Assistant Professor
    University of Alabama Medical Center
    Birmingham, AL, United States

    Disclosure information not submitted.

  • HJ

    Hari Jeyarajan, MD

    Department of Otolaryngology - Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, AL, United States

    Disclosure information not submitted.

  • KW

    Kirk Withrow

    Disclosure information not submitted.

  • PB

    Panuganti A. Bharat, MD

    Assistant Professor
    University of Alabama at Birmingham
    Birmingham, AL, United States

    Disclosure(s):

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

  • SM

    Susan D. McCammon, MD, PhD

    professor
    University of Alabama Heersink School of Medicine
    Birmingham, AL, United States

    Disclosure(s):

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

  • Benjamin J. Greene, MD

    Associate Professor
    University of Alabama at Birmingham
    Birmingham, AL, United States

    Disclosure(s):

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

    • Senior Author(s)

  • Carissa M. Thomas, MD, PhD

    Assistant Professor
    University of Alabama at Birmingham
    Birmingham, AL, United States

    Disclosure information not submitted.