Increasing use of nonsurgical therapy in advanced-stage oral cavity cancer: A population-based study
Richard B. Cannon MD
Otolaryngology Head and Neck Surgery, The University of Utah School of Medicine, Salt Lake City, Utah
Search for more papers by this authorJustin C. Sowder MD
Otolaryngology Head and Neck Surgery, The University of Utah School of Medicine, Salt Lake City, Utah
Search for more papers by this authorLuke O. Buchmann MD
Otolaryngology Head and Neck Surgery, The University of Utah School of Medicine, Salt Lake City, Utah
Huntsman Cancer Hospital, Salt Lake City, Utah
Department of Surgery, Division Otolaryngology, George E. Whalen VAMC, Salt Lake City, Utah
Search for more papers by this authorJason P. Hunt MD
Otolaryngology Head and Neck Surgery, The University of Utah School of Medicine, Salt Lake City, Utah
Huntsman Cancer Hospital, Salt Lake City, Utah
Search for more papers by this authorYing J. Hitchcock MD
Huntsman Cancer Hospital, Salt Lake City, Utah
Search for more papers by this authorKenneth F. Grossman MD, PhD
Huntsman Cancer Hospital, Salt Lake City, Utah
Search for more papers by this authorCorresponding Author
Marcus M. Monroe MD
Otolaryngology Head and Neck Surgery, The University of Utah School of Medicine, Salt Lake City, Utah
Huntsman Cancer Hospital, Salt Lake City, Utah
Department of Surgery, Division Otolaryngology, George E. Whalen VAMC, Salt Lake City, Utah
Corresponding author: M. M. Monroe, Otolaryngology Head and Neck Surgery, The University of Utah, 50 North Medical Dr., SOM 3C-120, Salt Lake City, UT 84132. E-mail: [email protected]Search for more papers by this authorRichard B. Cannon MD
Otolaryngology Head and Neck Surgery, The University of Utah School of Medicine, Salt Lake City, Utah
Search for more papers by this authorJustin C. Sowder MD
Otolaryngology Head and Neck Surgery, The University of Utah School of Medicine, Salt Lake City, Utah
Search for more papers by this authorLuke O. Buchmann MD
Otolaryngology Head and Neck Surgery, The University of Utah School of Medicine, Salt Lake City, Utah
Huntsman Cancer Hospital, Salt Lake City, Utah
Department of Surgery, Division Otolaryngology, George E. Whalen VAMC, Salt Lake City, Utah
Search for more papers by this authorJason P. Hunt MD
Otolaryngology Head and Neck Surgery, The University of Utah School of Medicine, Salt Lake City, Utah
Huntsman Cancer Hospital, Salt Lake City, Utah
Search for more papers by this authorYing J. Hitchcock MD
Huntsman Cancer Hospital, Salt Lake City, Utah
Search for more papers by this authorKenneth F. Grossman MD, PhD
Huntsman Cancer Hospital, Salt Lake City, Utah
Search for more papers by this authorCorresponding Author
Marcus M. Monroe MD
Otolaryngology Head and Neck Surgery, The University of Utah School of Medicine, Salt Lake City, Utah
Huntsman Cancer Hospital, Salt Lake City, Utah
Department of Surgery, Division Otolaryngology, George E. Whalen VAMC, Salt Lake City, Utah
Corresponding author: M. M. Monroe, Otolaryngology Head and Neck Surgery, The University of Utah, 50 North Medical Dr., SOM 3C-120, Salt Lake City, UT 84132. E-mail: [email protected]Search for more papers by this authorThis work was presented at the 2015 American Head and Neck Society (AHNS) Annual Meeting at the Combined Otolaryngology Society Meetings, Boston, MA, April 22–26, 2015.
Abstract
Background
National guidelines support surgical-based treatment and offer nonsurgical therapy as an alternative for advanced-stage oral cavity squamous cell carcinoma (SCC). There are limited data evaluating current utilization of these therapies and their survival outcomes.
Methods
A total of 5856 patients were found in the Surveillance, Epidemiology, and End Results (SEER) database from 1988 to 2008 with resectable advanced-stage oral cavity SCC tumors. Outcomes were disease-specific survival (DSS) and overall survival (OS).
Results
Surgical therapy had significantly improved mean DSS and OS (115 and 71 months, respectively) compared to nonsurgical therapy (63 and 35 months, respectively; p < .001). The use of nonsurgical therapy was significantly associated with the hard palate, and patients who were single, divorced, and black, with T3, T4, and N3 tumors, and the percent utilization has significantly increased from 12% to 20% (p < .05).
Conclusion
Utilization of nonsurgical therapy for advanced-stage oral cavity SCC is increasing and is independently associated with a reduction in survival, as well as patient factors traditionally associated with reduced access to medical care and advanced T and N classifications. © 2016 Wiley Periodicals, Inc. Head Neck 39: 82–91, 2017
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