In a new study conducted by the University of Minnesota, researchers found that patients with early laryngeal cancer have greater survival outcomes if their treatment includes surgery, even when they adjusted for other medical problems and sociodemographics.
The research conducted by University of Minnesota otolaryngologist, Stephanie Misono, M.D., M.P.H. and health policy expert, Schelomo Marmor, Ph.D., in conjunction with Bevan Yueh, MD MPH in otolaryngology and senior author Beth A. Virnig PhD, was a follow up study to their prior work, in which they saw a difference in survival outcomes between patients treated with surgery vs patients treated with radiation for their early laryngeal cancer, leading them to investigate if other medical conditions or sociodemographic factors influenced those results.
“Our initial thought was that health disparities might play a major role,” said Misono, the lead author of the study. ”We looked at an expanded data set which combined the Surveillance, Epidemiology, and End Results (SEER) data set and Medicare data files to include sociodemographic information and other medical diagnoses. Even with concurrent medical conditions, facility and socio-demographic characteristics, we still saw a difference in survival depending on treatment type.”
Based on previous research, the outcomes for both surgery and radiation have been considered essentially equal, so these findings raise some interesting questions. Most patients who are diagnosed with laryngeal cancer are treated with radiation.
“We would like to understand why most patients receive radiation,” said Misono. “Is surgery readily available? Do patients have an opportunity to make a choice? How are they counseled? What decision-making process is taking place? How is that decision-making process reflected in survival outcomes?” Although they say more research is needed before considering changes in treatment guidelines, the findings have prompted them to rethink their assumptions and provide more nuanced counseling for patients. “We want to direct both researchers and patients to our findings, so through more research and collaboration, we can all work together to learn how to help each patient identify his or her best treatment options,” said Misono.
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