title: T1 glottic carcinoma: do comorbidities, facility characteristics, and sociodemographics explain survival differences across treatment?
abstract: OBJECTIVE
  Recent large-scale studies have observed differences in survival following treatment for early laryngeal carcinoma depending on treatment type but were not able to take sociodemographic, comorbidity, and facility data into account. The objective of this study was to determine whether survival differences across treatment types persist when these factors are included in the analysis.
  
  
  METHODS
  Retrospective cohort analysis.
  
  
  METHODS
  Linked Surveillance, Epidemiology, and End Results (SEER)-Medicare data files.
  
  
  METHODS
  Medicare beneficiaries who were identified through the SEER registries (1991-2009) as having T1 glottic squamous cell carcinoma (scca) and a known treatment type were included.
  
  
  RESULTS
  A total of 2338 patients with incident T1 glottic scca were identified. Most were white and male. Treatment type was radiation only in 47%, local surgery and radiation in 39%, and local surgery only in 14%. Black race and increased comorbidities were associated with worse survival. When sociodemographics, comorbidities, and facility characteristics were taken into account, survival differences were observed across treatment types, with those receiving local surgery demonstrating better overall and cancer-specific survival.
  
  
  CONCLUSIONS
  These results suggest that following treatment of T1 glottic scca, there may be survival differences across treatment types beyond those explained by sociodemographic, comorbidity, and facility characteristics.
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA smisono@umn.edu.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Misono
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA Department of Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: Schelomo
authors.initials: S
authors.lastname: Marmor
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: Bevan
authors.initials: B
authors.lastname: Yueh
authors.affiliation: Division of Health Policy & Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: Beth A
authors.initials: BA
authors.lastname: Virnig
mesh_terms: D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D015897:Comorbidity; D005260:Female; D005931:Glottis / Q000473:pathology; D006801:Humans; D007822:Laryngeal Neoplasms / Q000453:epidemiology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology / Q000473:pathology; D012907:Smoking / Q000453:epidemiology; D016019:Survival Analysis
keywords: endoscopic laryngeal surgery; glottic cancer; laryngeal cancer; radiation; survival