Study: HNSCC Outcomes in Blacks Similar to Whites

Stage IVA HPV-positive squamous cell carcinoma of the head and neck

Black race did not adversely affect outcomes after receiving radiotherapy for head and neck squamous cell carcinoma compared with white race, according to the results of a study in which black patients made up the majority of enrolled participants.

Previous research has indicated that black patients diagnosed with head and neck squamous cell carcinoma (HNSCC) had higher mortality rates and decreased disease-free survival, cause-specific survival and distant metastases. However, the studies from which these conclusions were drawn included only a minority of black patients among the patient population.

“The University of Illinois at Chicago features a unique patient demographic in which blacks comprise the majority of patients treated,” wrote Gene-Fu F. Liu, MD, and colleagues from the university. “To this end, we sought to determine the extent of racial disparities in the outcomes of patients with HNSCC in which blacks comprise a large proportion of the population.

They conducted a retrospective review of outcomes from 366 black and 236 white patients with nonmetastatic HNSCC who were treated with radiotherapy from 1990 to 2012. The results of the study were published in Cancer.

The overall patient population was followed for a median of 18.3 months with the median follow-up for blacks significantly longer than that for whites (21.5 months vs 15.4 months; P = .05).

Results indicated that white patients were more likely to have undergone surgery prior to radiotherapy than black patients (P = .05). Excluding the treatment of primary oral cavity tumors, similar rates of postoperative radiotherapy were seen between black and white patients. In addition, black and white patients received similar rates of induction and concurrent chemotherapy.

After undergoing treatment, blacks had a 2-year locoregional control rate of 71.9% compared with 64.2% in white patients. Although univariate analysis showed that blacks had an improved rate of locoregional control, the results between whites and black were not significantly different on multivariate analysis. In addition, the researchers found no significant differences in progression-free survival and overall survival for black patients compared with white patients.

“It is likely that biologic and patient-specific socioeconomic factors cannot adequately explain racial differences in outcomes among patients with HNSCC,” the researchers wrote. “We propose that centers caring for a greater percentage of minority patients may have unique patient-health care provider relationships to overcome racial disparities in health care. Thus, these results may be applicable to other cancers and other nonmalignant diseases.”