title: Increasing use of nonsurgical therapy in advanced-stage oral cavity cancer: A population-based study.
abstract: National guidelines support surgical-based treatment and offer nonsurgical therapy as an alternative for advanced-stage oral cavity squamous cell carcinoma (SCC). There are limited data evaluating current utilization of these therapies and their survival outcomes.
  
  
  
  A total of 5856 patients were found in the Surveillance, Epidemiology, and End Results (SEER) database from 1988 to 2008 with resectable advanced-stage oral cavity SCC tumors. Outcomes were disease-specific survival (DSS) and overall survival (OS).
  
  
  
  Surgical therapy had significantly improved mean DSS and OS (115 and 71 months, respectively) compared to nonsurgical therapy (63 and 35 months, respectively; p < .001). The use of nonsurgical therapy was significantly associated with the hard palate, and patients who were single, divorced, and black, with T3, T4, and N3 tumors, and the percent utilization has significantly increased from 12% to 20% (p < .05).
  
  
  
  Utilization of nonsurgical therapy for advanced-stage oral cavity SCC is increasing and is independently associated with a reduction in survival, as well as patient factors traditionally associated with reduced access to medical care and advanced T and N classifications. © 2016 Wiley Periodicals, Inc. Head Neck 39: 82-91, 2017.
authors.affiliation: Otolaryngology Head and Neck Surgery, The University of Utah School of Medicine, Salt Lake City, Utah.
authors.forename: Richard B
authors.initials: RB
authors.lastname: Cannon
authors.affiliation: Otolaryngology Head and Neck Surgery, The University of Utah School of Medicine, Salt Lake City, Utah.
authors.forename: Justin C
authors.initials: JC
authors.lastname: Sowder
authors.affiliation: Otolaryngology Head and Neck Surgery, The University of Utah School of Medicine, Salt Lake City, Utah.|Huntsman Cancer Hospital, Salt Lake City, Utah.|Department of Surgery, Division Otolaryngology, George E. Whalen VAMC, Salt Lake City, Utah.
authors.forename: Luke O
authors.initials: LO
authors.lastname: Buchmann
authors.affiliation: Otolaryngology Head and Neck Surgery, The University of Utah School of Medicine, Salt Lake City, Utah.|Huntsman Cancer Hospital, Salt Lake City, Utah.
authors.forename: Jason P
authors.initials: JP
authors.lastname: Hunt
authors.affiliation: Huntsman Cancer Hospital, Salt Lake City, Utah.
authors.forename: Ying J
authors.initials: YJ
authors.lastname: Hitchcock
authors.affiliation: Huntsman Cancer Hospital, Salt Lake City, Utah.
authors.forename: Shane
authors.initials: S
authors.lastname: Lloyd
authors.affiliation: Huntsman Cancer Hospital, Salt Lake City, Utah.
authors.forename: Kenneth F
authors.initials: KF
authors.lastname: Grossman
authors.affiliation: Otolaryngology Head and Neck Surgery, The University of Utah School of Medicine, Salt Lake City, Utah.|Huntsman Cancer Hospital, Salt Lake City, Utah.|Department of Surgery, Division Otolaryngology, George E. Whalen VAMC, Salt Lake City, Utah.
authors.forename: Marcus M
authors.initials: MM
authors.lastname: Monroe
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D009367:Neoplasm Staging; D018426:SEER Program; D012959:Socioeconomic Factors; D016019:Survival Analysis; D015996:Survival Rate
keywords: Epidemiology; Surveillance; advanced-stage oral cavity cancer; and End Results (SEER) database; increasing use of nonsurgical therapy; long-term survival outcomes; population-based study