Head & neck · 2019
Factors predicting for patient refusal of head and neck cancer therapy.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Amini Arya, Verma Vivek, Li Richard, Vora Nayana, Kang Robert, Gernon Thomas J, Chang Sue, Karam Sana, Massarelli Erminia, Maghami Ellie G, Glaser Scott
Аннотация
BACKGROUND: The purpose of this study was to evaluate the national rate of treatment refusal in head and neck cancer (HNC).
METHODS: The National Cancer Database was queried for nonmetastatic squamous cell carcinoma of the head and neck. Oncologic therapy referred to receipt of surgery, radiotherapy, or chemotherapy.
RESULTS: Compared to the 230 424 patients who received treatment, 2965 (1.3%) were reported to have refused definitive therapy. Predictors included older age, female sex, African-American/other race, nonprivate insurance, greater comorbidities, more advanced disease, and residence closer to the treating facility (P < .05). Patients with a prior history of cancer, Hispanic race, those treated at academic centers, and those from higher income counties were less likely to refuse therapy (P < .05). Patients who refused definitive therapy experienced poorer survival (median 79.1 vs 8.7 months, P < .001).
CONCLUSIONS: Refusing oncologic therapy is relatively rare in HNC and appears to be multifocal in nature.
METHODS: The National Cancer Database was queried for nonmetastatic squamous cell carcinoma of the head and neck. Oncologic therapy referred to receipt of surgery, radiotherapy, or chemotherapy.
RESULTS: Compared to the 230 424 patients who received treatment, 2965 (1.3%) were reported to have refused definitive therapy. Predictors included older age, female sex, African-American/other race, nonprivate insurance, greater comorbidities, more advanced disease, and residence closer to the treating facility (P < .05). Patients with a prior history of cancer, Hispanic race, those treated at academic centers, and those from higher income counties were less likely to refuse therapy (P < .05). Patients who refused definitive therapy experienced poorer survival (median 79.1 vs 8.7 months, P < .001).
CONCLUSIONS: Refusing oncologic therapy is relatively rare in HNC and appears to be multifocal in nature.