title: Determinants of racial differences in survival for sinonasal cancer.
abstract: Racial differences in survival are present across multiple cancer types, including sinonasal cancer. Thus far in the literature, reasons for this have been theorized but not proven. We aimed to examine proposed potential factors and understand the true determinants in racial differences for survival in sinonasal cancer.
  
  
  
  Utilizing the U.S. National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER)-Medicare database (2000-2008), we analyzed multiple demographic, tumor-related, and treatment-related factors. Use of the Medicare subset allows much deeper examination of patient and treatment factors than the usual SEER database study.
  
  
  
  Univariate analysis and multivariate Cox proportional hazard regression models were used.
  
  
  
  Eight hundred and forty-five patients remained after exclusion criteria. Five-year cause-specific survival (CSS) was 62%, with a racial difference confirmed because non-Hispanic whites (NHW) and blacks and Hispanic whites (B/HW) demonstrated 64% and 52% CSS, respectively. After multivariate analysis, factors significantly determining racial survival were age, stage, histology, grade, comorbidity status, and standard of care.
  
  
  
  This study confirms the difference in racial survival in sinonasal cancer. In opposition to popular theories of access to care and education level- and poverty level-determining outcomes, those factors were not significant on multivariate analysis, whereas stage and receiving standard of care, determined by unimodality versus multimodality treatment appropriate to stage, were the two most important prognostic factors.
  
  
  
  2c. Laryngoscope, 126:2022-2028, 2016.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, U.S.A.
authors.forename: Zara M
authors.initials: ZM
authors.lastname: Patel
authors.affiliation: Rollins School of Public Health, Department of Epidemiology, Emory University School of Medicine, Atlanta, Georgia, U.S.A.
authors.forename: Juan
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, U.S.A.
authors.forename: Amy Y
authors.initials: AY
authors.lastname: Chen
authors.affiliation: Rollins School of Public Health, Department of Epidemiology, Emory University School of Medicine, Atlanta, Georgia, U.S.A.
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Ward
mesh_terms: D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D010255:Paranasal Sinus Neoplasms / Q000401:mortality*; D015996:Survival Rate; D044465:White People
keywords: Paranasal sinus cancer; cancer outcomes; cancer prognosis; nasal cancer; race; racial differences; sinonasal cancer; sinus cancer; survival