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Scientific Oral Presentations

Head and Neck Surgery

Session: Scientific Oral Presentations 9 - Head and Neck Surgery

Factors Associated With Adherence to Adjuvant Treatment in Patients With Oropharyngeal Squamous Cell Carcinoma

Tuesday, October 1, 2024
9:42 AM – 9:48 AM EDT
Location: MBCC, 208
Disclosure(s):
Shravan Asthana, BS:

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

Asher C. Park, BS:

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

Jaymie A. Bromfield, MPH:

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

Abhinav A. Talwar, MD, MBA:

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

Urjeet a. Patel, MD:

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

Introduction: Adjuvant treatments are critical components in oropharyngeal squamous cell carcinoma (OPSCC) management. This study investigates adjuvant treatment location and patient level factors associated with adjuvant treatment adherence in OPSCC.

Methods: Patients with OPSCC diagnosed between 2007 and 2019, undergoing definitive surgery and recommended adjuvant therapy, were analyzed. Adherence was defined as documented patient completion of modality and quantity of recommended radiation or chemoradiation. A backward elimination approach was employed for the final logistic regression model, removing the least significant variables until p < 0.2 for remaining variables.

Results: Of the 169 patients included in this study, patients were mostly White (91.7%), privately insured (62.7%), and adherent to their regimens (85.8%). 85.5% of patients recommended chemoradiation adhered, whereas only 74.4% recommended radiation alone adhered. Upon univariate analysis, Medicare payer (OR=0.44, p=0.037) and age (OR=0.96, p=0.0063) were associated with poor adherence. Adjuvant treatment locations were mostly tertiary care level (47.3%) and urban (88.2%). Multivariate logistic regression models indicated care level (Tertiary: AOR=4.48, p=0.008; Quaternary: AOR=4.12, p=0.024) and adjuvant treatment location social vulnerability (AOR=0.05, p=0.033) were significant hospital-level predictors of adherence.

Conclusions: Higher levels of care are associated with better treatment adherence while Medicare coverage and high adjuvant treatment location social vulnerability are associated with poor treatment adherence. Further exploration of socioeconomic drivers for non-tertiary adjuvant care as well as adjuvant treatment associated dosing and toxicity in Medicare patients is warranted.

    Presenting Author(s)

  • SA

    Shravan Asthana, BS

    Medical Student
    Feinberg School of Medicine
    Chicago, IL, United States

    Disclosure(s):

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

  • JB

    Jaymie A. Bromfield, MPH

    Clinical Research Coordinator
    Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology- Head and Neck Surgery, Northwestern McGraw Medical Center
    Chicago, IL, United States

    Disclosure(s):

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

    • Co-Author(s)

  • AP

    Asher C. Park, BS

    Medical Student
    Northwestern University - Feinberg School of Medicine
    Chicago, IL, United States

    Disclosure(s):

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

  • Abhinav A. Talwar, MD, MBA

    Resident Physician
    Northwestern Memorial Hospital
    Roslyn, New York, United States

    Disclosure(s):

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

  • OD

    Olivia E. Dunne, BS

    Research Study Coordinator
    Northwestern Memorial Hospital
    Mamaroneck, NY, United States

    Disclosure information not submitted.

  • Urjeet A. Patel, MD

    Professor
    Feinberg School of Medicine
    chicago, Illinois, United States

    Disclosure(s):

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

  • SS

    Sandeep Samant, MD

    Professor
    Northwestern University Department of Otolaryngology - Head and Neck Surgery
    Chicago, Illinois, United States

    Disclosure information not submitted.

  • LG

    Laila Gharzai, MD

    Feinberg School of Medicine, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • Katelyn O. Stepan, MD

    Assistant Professor
    Northwestern Memorial Hospital
    Chicago, IL, United States

    Disclosure information not submitted.