Asian and non-Asian disparities in outcomes of non-nasopharyngeal head and neck cancer.

Autor: Kim JD; Division of Medical Oncology, University of British Columbia, British Columbia Cancer Agency, Vancouver, British Columbia, Canada., Chang JT; Division of Medical Oncology, University of British Columbia, British Columbia Cancer Agency, Vancouver, British Columbia, Canada., Moghaddamjou A; Division of Medical Oncology, University of British Columbia, British Columbia Cancer Agency, Vancouver, British Columbia, Canada., Kornelsen EA; Department of Oncology, University of Calgary, Tom Baker Cancer Center, Calgary, Alberta, Canada., Ruan JY; Division of Medical Oncology, University of British Columbia, British Columbia Cancer Agency, Vancouver, British Columbia, Canada., Olson RA; Division of Medical Oncology, University of British Columbia, British Columbia Cancer Agency, Vancouver, British Columbia, Canada., Cheung WY; Department of Oncology, University of Calgary, Tom Baker Cancer Center, Calgary, Alberta, Canada.
Jazyk: angličtina
Zdroj: The Laryngoscope [Laryngoscope] 2017 Nov; Vol. 127 (11), pp. 2528-2533. Date of Electronic Publication: 2017 Apr 11.
DOI: 10.1002/lary.26603
Abstrakt: Objectives/hypothesis: To evaluate disparities in overall survival (OS) between Asian and non-Asian patients diagnosed with non-nasopharyngeal head and neck cancer (HNC).
Study Design: This was a population-based, retrospective study of patients diagnosed with non-nasopharyngeal HNC of squamous cell carcinoma histology between 2001 and 2010 in British Columbia, Canada.
Methods: Using Kaplan-Meier methods and Cox regression models, we examined the relationship between race and OS.
Results: A total of 3,036 patients were included in the study. Median age was 64 years, 74% were men, and 7% were Asians. Asians had worse Eastern Cooperative Oncology Group (ECOG) status (29% vs. 23%, P = .07) and larger tumors (33% vs. 21%, P = .02), and were more likely to be diagnosed with oral cavity cancers (38% vs. 25%, P < .001) than non-Asians. Asians were also less likely to receive multimodality therapy than non-Asians (90% vs. 95%, P = .02). Asians were more likely to have never smoked (49% vs. 15%, P < .001) and to be married or with a partner (80% vs. 69%, P = .02). Multivariate models showed that Asians had better OS than non-Asians (hazard ratio [HR] = 0.50, 95% confidence interval [CI] = 0.25-0.99, P = .05). Three-year OS did not differ significantly between Asians and non-Asians (41% vs. 42%, P = .18); however, 5-year OS did (22% vs. 19% P = .03). Stratifying by treatment type, outcomes were comparable in both groups except for radiotherapy alone, where Asians showed significantly better OS (HR = 0.71, 95% CI = 0.51-0.99, P = .04). Advanced age, worse ECOG, greater tumor size, and lack of treatment also correlated with inferior OS.
Conclusions: Despite several worse prognostic features and less aggressive treatment, Asians tended to exhibit better OS than non-Asians.
Level of Evidence: 2c. Laryngoscope, 127:2528-2533, 2017.
(© 2017 The American Laryngological, Rhinological and Otological Society, Inc.)
Databáze: MEDLINE
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