Longitudinal Oncology Registry of Head and Neck Carcinoma (LORHAN): Analysis of African American patients.

Abstract

5533 Background: Previous retrospective analyses show poor outcomes for African American (AA) patients with head and neck carcinoma (HNC). Such racial disparities are not well understood, but patient (pt) demographics, comorbidities, tumor site, and human papillomavirus (HPV) status are suggested to play a role. Methods: The LORHAN registry was used to identify pts ≥18 yrs of age with de novo, non-metastatic HNC, and a record of survival time. This study evaluated pt and treatment characteristics by race, and conducted adjusted Cox regression analyses of overall survival (OS) and progression-free survival (PFS) to identify prognostic factors and interactions, and estimate hazard ratios (HRs) of AA vs. non-Hispanic white (NHW). Results: Baseline pt characteristics (see table below). The median OS/3-yr rate was 41.7 mo/51% in AA vs. 52.9 mo/70% in NHW, (age-adjusted HR: 1.73 [95% CI: 1.45, 2.08]). The median PFS/3-yr rate was 29.6 mo/43% in AA and 49.9 mo/62% in NHW, (age-adjusted HR: 1.64 [95%CI: 1.40, 1.93]). Multivariate analysis of OS and PFS showed that AA race, stage III and IV, PS 2, and smoking were significantly associated with a worse HR, while OP demonstrated a favorable HR over other sites. Significant interaction tests led to subgroup analyses for OS showing an elevated risk in AA with OP (HR: 2.62 [95%CI: 1.95, 3.52]) and similar risk elevations in male AA as well as in AA with PS 0-1 when compared to NHW in the corresponding subgroups. Conclusions: Controlling for other factors like PS and smoking, a worse prognosis was seen in AA males with OP localized SCCHN. Further investigation to improve the outcomes in this population is warranted. [Table: see text]