Marital status and head and neck cancer outcomes

18 Background: The impact of marital status on cancer survival, including head and neck cancer (HNC), has been previously described. However, no previous study has shown whether being married impacts head and neck cancer patients with end-stage disease. The objective of this study was to determine the impact of marital status on survival of patients with stage IVc HNC. Methods: Patients ≥18 years from the Surveillance, Epidemiology, and End Results (SEER) database diagnosed with end-stage (AJCC stage IVc) head and neck squamous cell carcinoma from 2007-2015 ( n=2,886) were included. Kaplan-Meier survival estimated crude survival differences stratified by marital status (married/partnered, never married, divorced/separated, widowed) using log-rank test, and in-between differences were determined using Bonferroni adjustments. Competing risks proportional hazards model determined the effect of marital status on death from HNC while controlling for covariates (age, year of diagnosis, county-level poverty percentage, sex, race/ethnicity, insurance, anatomic subsite, and treatment modality). Results: Patients were predominantly male (81%) and white (65%), with mean age of 62 years. Median overall survival for the cohort was 11 months. The Kaplan-Meier curves indicated at the end of follow-up that divorced/separated (HNSCC-specific survival percentage=13%), never married (8%), and widowed patients (12%) had significantly lower survival than married/partnered patients (20%) (Bonferroni p<0.01). After adjusting for covariates, the proportional hazards model indicated that divorced/separated (aHR=1.16, 95% CI 1.01, 1.33), never married (aHR=1.20, 95% CI 1.07, 1.36), and widowed patients (aHR=1.23, 95% CI 1.02, 1.48) were significantly more likely to die from HNSCC than married/partnered patients. Conclusions: Married patients with HNC enjoy better survival outcomes than those unmarried, and those widowed and divorced have worse outcomes. This study illustrates that supportive care, in the form of being married, impacts patients, including those with end-stage disease.

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Multidisciplinary Service Utilization Pattern by Advanced Head and Neck Cancer Patients: A Single Institution Study

International Journal of Otolaryngology ◽

10.1155/2012/628578 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Jacqueline C. Junn ◽

Irene A. Kim ◽

Marianna L. Zahurak ◽

Marietta Tan ◽

Katherine Y. Fan ◽

...

Keyword(s):

Multivariate Analysis ◽

Head And Neck Cancer ◽

Social Work ◽

Marital Status ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Stage Iv ◽

Female Gender ◽

Stage Iv Disease

Purpose. To analyze the patterns and associations of adjunctive service visits by head and neck cancer patients receiving primary, concurrent chemoradiation therapy.Methods. Retrospective chart review of patients receiving adjunctive support during a uniform chemoradiation regimen for stages III-IV head and neck squamous cell carcinoma. Univariate and multivariate models for each outcome were obtained from simple and multivariate linear regression analyses.Results. Fifty-two consecutive patients were assessed. Female gender, single marital status, and nonprivate insurance were factors associated with an increased number of social work visits. In a multivariate analysis, female gender and marital status were related to increased social work services. Female gender and stage IV disease were significant for increased nursing visits. In a multivariate analysis for nursing visits, living greater than 20 miles between home and hospital was a negative predictive factor.Conclusion. Treatment of advanced stage head and neck cancer with concurrent chemoradiation warrants a multidisciplinary approach. Female gender, single marital status, and stage IV disease were correlated with increased utilization of social work and nursing services. Distance over 20 miles from the center was a negative factor. This information may help guide the treatment team to allocate resources for the comprehensive care of patients.

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