Association of Race/Ethnicity, Stage, and Survival in Oral Cavity Squamous Cell Carcinoma: A SEER Study

Abstract

ObjectiveSurvival differences in oral cancer between black and white patients have been reported, but the contributing factors, especially the role of stage, are incompletely understood. Furthermore, the outcomes for Hispanic and Asian patients have been scarcely examined.Study DesignRetrospective, population-based national study.SettingSurveillance, Epidemiology, and End Results 18 Custom database (January 1, 2010, to December 31, 2014).Subjects and MethodsIn total, 7630 patients with primary squamous cell carcinoma in the oral cavity were classified as non-Hispanic white (white), non-Hispanic black (black), Hispanic, or Asian. Cox regression was used to obtain unadjusted and adjusted hazard ratios (HRs) of 5-year mortality for race/ethnicity with sequential adjustments for stage and other covariates. Logistic regression was used to examine the relationship between race/ethnicity and stage with adjusted odds ratios (aORs).ResultsThe cohort consisted of 75.0% whites, 7.6% blacks, 9.1% Hispanics, and 8.3% Asians. Compared to whites, the unadjusted HR for all-cause mortality for blacks was 1.68 (P < .001), which attenuated to 1.15 (P = .039) after adjusting for stage and became insignificant after including insurance. The unadjusted HRs for all-cause mortality were not significant for Hispanics and Asians vs whites. Compared to whites, blacks and Hispanics were more likely to present at later stages (aORs of 2.63 and 1.42, P < .001, respectively).ConclusionThe greater mortality for blacks vs whites was largely attributable to the higher prevalence of later stages at presentation and being uninsured among blacks. There was no statistically significant difference in mortality for Hispanics vs whites or Asians vs whites.

The REASON score: an epigenetic and clinicopathologic score to predict risk of poor survival in patients with early stage oral squamous cell carcinoma

“…Each year 30,000 Americans are diagnosed with oral cavity squamous cell carcinoma (OSCC) and 80% of newly diagnosed cases are early stage I/II without regional lymph node involvement or distant metastasis. Even for early stage oral cancer patients, the five-year survival rate is as low as 60% [ 4 – 6 ]. The mortality rate is worse in racially and socioeconomically disadvantaged groups.…”

“…The mortality rate is worse in racially and socioeconomically disadvantaged groups. A study using the Surveillance, Epidemiology, and End Results (SEER) database indicates that while black patients only make up 7.6% of all OSCC patients, with 75% of patients being white, black patients are significantly more likely to die of OSCC, which is partially a result of a later stage at diagnosis and access to healthcare or health coverage [ 6 ]. OSCC patients are treated with surgical resection of the cancer and neck lymphadenectomy, followed by adjuvant radiation with or without chemotherapy and immunotherapy based on risk stratification.…”

Favorable Lip and Oral Cancer Mortality-To-Incidence Ratios in Countries With High Human Development Index and Expenditures On Health

“…Recently, immunotherapy has emerged as a potential and effective treatment [8,10]. The prognosis of oral cancer is related to several factors, such as race [11] and anatomic subsites [12]. Moreover, the early detection of oral cancer is one of the most important factors that affect the overall survival and prognosis [13], since an affordable examination target to oral cancer can help early diagnosis and improve the prognosis and survival rate [14], and the prognosis has disparities in socioeconomic status [15].…”

Anti-Tumoral Effects of A Benzimidazolyl Carbamate Ester Derivative on Head and Neck Squamous Carcinoma Cell Lines

“…To this aim, we evaluated the activity of RDS 60 in terms of anti-mitotic and apoptosis inducer agent and we tested its potential antitumoral e ciency directed to human head and neck squamous cell carcinomas (HNSCC), a group of tumors detectable in various regions of the oral cavity, oropharynx, hypopharynx and larynx. We chose these types of neoplasms because they are extremely aggressive; in fact, almost 50% of the newly diagnosed HNSCC has a survival rate below 5 years [11]. HNSCC are collocated at the sixth position among malign tumors more diffuse in the world [12] and they are all characterized by a poor prognosis, mainly due to metastases, to the development of multiple primary tumors and to local and regional often inoperable relapses [13,14].…”