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Comparative Study
. 2009 Sep;2(9):782-91.
doi: 10.1158/1940-6207.CAPR-09-0154. Epub 2009 Sep 8.

Matched-pair analysis of race or ethnicity in outcomes of head and neck cancer patients receiving similar multidisciplinary care

Affiliations
Comparative Study

Matched-pair analysis of race or ethnicity in outcomes of head and neck cancer patients receiving similar multidisciplinary care

Leon M Chen et al. Cancer Prev Res (Phila). 2009 Sep.

Abstract

It is unknown whether population-level racial or ethnic disparities in mortality from squamous cell carcinoma of the head and neck (SCCHN) also occur in the setting of standardized multidisciplinary-team directed care. Therefore, we conducted a matched-pair study that controlled for several potentially confounding prognostic variables to assess whether a difference in survival exists for African American or Hispanic American compared with non-Hispanic white American SCCHN patients receiving similar care. Matched pairs were 81 African American case and 81 non-Hispanic white control patients and 100 Hispanic American cases and 100 matched non-Hispanic white controls selected from 1,833 patients of a prospective epidemiologic study of incident SCCHN within a single, large multidisciplinary cancer center. Matching variables included age (+/-10 years), sex, smoking status (never versus ever), site, tumor stage (T(1-2) versus T(3-4)), nodal status (negative versus positive), and treatment. Cases and controls were not significantly different in proportions of comorbidity score, alcohol use, subsite distribution, overall stage, or tumor grade. Matched-pair and log-rank analyses showed no significant differences between cases and controls in recurrence-free, disease-specific, or overall survival. Site-specific analyses suggested that more aggressive oropharyngeal cancers occurred more frequently in minority than in non-Hispanic white patients. We conclude that minority and non-Hispanic white SCCHN patients receiving similar multidisciplinary-team directed care at a tertiary cancer center have similar survival results overall. These results encourage reducing health disparities in SCCHN through public-health efforts to improve access to multidisciplinary oncologic care (and to preventive measures) and through individual clinician efforts to make the best multidisciplinary cancer treatment choices available for their minority patients. The subgroup finding suggests a biologically based racial/ethnic disparity among oropharyngeal patients and that prevention and treatment strategies should be tailored to different populations of these patients.

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Conflict of interest statement

Disclosures of Potential Conflicts of Interest

No potential conflicts of interest were disclosed.

Figures

Fig. 1
Fig. 1
Survival of African-American case and matched non-Hispanic white control patients with squamous cell carcinoma of the head and neck. The case group is represented by solid lines, the control group by dashed lines; A, recurrence-free survival (P = 0.569); B, disease-specific survival (P = 0.826); C, overall survival (P = 0.536).
Fig. 1
Fig. 1
Survival of African-American case and matched non-Hispanic white control patients with squamous cell carcinoma of the head and neck. The case group is represented by solid lines, the control group by dashed lines; A, recurrence-free survival (P = 0.569); B, disease-specific survival (P = 0.826); C, overall survival (P = 0.536).
Fig. 1
Fig. 1
Survival of African-American case and matched non-Hispanic white control patients with squamous cell carcinoma of the head and neck. The case group is represented by solid lines, the control group by dashed lines; A, recurrence-free survival (P = 0.569); B, disease-specific survival (P = 0.826); C, overall survival (P = 0.536).
Fig. 2
Fig. 2
Survival of Hispanic-American case and matched non-Hispanic white control patients with squamous cell carcinoma of the head and neck. The case group is represented by solid lines, the control group by dashed lines; A, recurrence-free survival (P = 0.954); B, disease-specific survival (P = 0.873); C, overall survival (P = 0.844).
Fig. 2
Fig. 2
Survival of Hispanic-American case and matched non-Hispanic white control patients with squamous cell carcinoma of the head and neck. The case group is represented by solid lines, the control group by dashed lines; A, recurrence-free survival (P = 0.954); B, disease-specific survival (P = 0.873); C, overall survival (P = 0.844).
Fig. 2
Fig. 2
Survival of Hispanic-American case and matched non-Hispanic white control patients with squamous cell carcinoma of the head and neck. The case group is represented by solid lines, the control group by dashed lines; A, recurrence-free survival (P = 0.954); B, disease-specific survival (P = 0.873); C, overall survival (P = 0.844).
Fig. 3
Fig. 3
Survival of minority case and matched non-Hispanic white control patients with oropharyngeal cancer. The case group is represented by solid lines, the control group by dashed lines; A, recurrence-free survival (P = 0.028); B, disease-specific survival (P = 0.067); C, overall survival (P = 0.004).
Fig. 3
Fig. 3
Survival of minority case and matched non-Hispanic white control patients with oropharyngeal cancer. The case group is represented by solid lines, the control group by dashed lines; A, recurrence-free survival (P = 0.028); B, disease-specific survival (P = 0.067); C, overall survival (P = 0.004).
Fig. 3
Fig. 3
Survival of minority case and matched non-Hispanic white control patients with oropharyngeal cancer. The case group is represented by solid lines, the control group by dashed lines; A, recurrence-free survival (P = 0.028); B, disease-specific survival (P = 0.067); C, overall survival (P = 0.004).

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