Publication Abstract

Authors: Jean RA, Kallogjeri D, Strope SA, Hardin FM, Rich JT, Piccirillo JF

Title: Exploring SEER-Medicare for changes in the treatment of laryngeal cancer among elderly medicare beneficiaries.

Journal: Otolaryngol Head Neck Surg 150(3):419-27

Date: 2014 Mar

Abstract: OBJECTIVE: To explore the change in frequency of treatment, and its association with 5-year survival, among elderly Medicare enrollees with squamous cell carcinoma of the larynx (SCCL). STUDY DESIGN: Retrospective analysis of a national cancer database. SUBJECTS AND METHODS: This was an analysis of the Surveillance, Epidemiology, and End Results (SEER)-Medicare data set of elderly patients diagnosed with SCCL between 1992 and 2007. Surgical and nonsurgical treatments were identified, and changes in frequency by year of cancer diagnosis were explored. A propensity-matched multivariate Cox proportional hazards model was used to compare the impact of treatment. RESULTS: There were 3324 cases of primary SCCL diagnosed between 1992 and 2007 studied. Most were male (n = 2605; 78%), white (n = 2845; 87%), and between 66 and 74 years of age (n = 1874; 56%). Between 1992 and 2005, there was a significant trend for increasing 5-year overall survival (43% in 1992 to 54% in 2005-2007; P < .01). There was a significant trend for decreasing frequency of surgical therapy (47% in 1992-1995 to 41% in 2005-2007; P = .03). Surgical therapy was associated with a decreased risk of overall mortality (hazard ratio, 0.76; 95% confidence interval, 0.68-0.86) in comparison to nonsurgical treatments. CONCLUSION: The analysis demonstrates an increase in survival among elderly Medicare enrollees diagnosed with SCCL between 1992 and 2007. Despite a significant trend for its decreasing use, there was a significantly decreased risk of overall mortality associated with surgical therapy.