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The prognosis and treatment of newly diagnosed bone metastasis of head and neck squamous cell cancer: an analysis of racial disparity

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Abstract

Objective

There is a lack of research investigating racial disparity in newly diagnosed head and neck squamous cell carcinoma with isolated bone metastases (HNSCC-BM). This study aims to investigate the clinical characteristics and prognostic factors in HNSCC-BM patients from different racial backgrounds to aid clinical decision making and management.

Methods

We retrieved data from the Surveillance, Epidemiology, and End Results (SEER) database for 345 cases of HNSCC-BM that were diagnosed between 2010 and 2017. Survival was compared using univariate and multivariate Cox proportional hazards models, Kaplan–Meier analysis, and log-rank tests. We also used propensity score matching to adjust for confounders.

Results

In white patients, those who were over 40 years of age had a significantly shorter survival (HR, 4.49; 95% CI 1.03–19.56; P < 0.05). Female black patients were found to survive longer compared to male patients (HR, 0.34; 95% CI 0.15–0.76; P < 0.01). Single (never married) Asians had shorter survival than married Asians (HR, 4.68; 95% CI 1.34–16.41; P < 0.05). In all three racial groups, patients who received radiotherapy in addition to chemotherapy did not survive longer than those receiving chemotherapy (P > 0.05). In Asian patients, those who underwent surgery at the primary site combined with chemoradiotherapy had significantly better survival outcomes than those who received chemoradiotherapy (HR: 0.10, 95% CI 0.01–0.88; P = 0.01).

Conclusion

Prognostic factors differ between HNSCC-BM patients from different racial backgrounds.

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Data availability

The data presented in this study are available on request from the corresponding author.

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Funding

This study was supported by National Natural Science Foundation of China (82173341), Natural Science Foundation of Hunan (2023JJ20087), Changsha Distinguished Young Scholars grant (kq2209007), and The science and technology innovation Program of Hunan Province (2023RC3082), National Natural Science Foundation of China (82303133), China Postdoctoral Science Foundation (2022M723559), Natural Science Foundation of Hunan Province (2020JJ5867), and the Project of Hunan Health Commission (B202307017799).

Author information

Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, The Second **angya Hospital, Central South University, Changsha, China

    Huimei Huang, Shiying Zeng, **aojun Tang, Qian Yang, Qinglai Tang, Danhui Yin, Shisheng Li & Gangcai Zhu

  2. Department of Otolaryngology-Head and Neck Surgery, The Third **angya Hospital, Central South University, Changsha, China

    Yuexiang Qin

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  1. Huimei Huang
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  2. Shiying Zeng
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  3. **aojun Tang
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  4. Qian Yang
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  6. Qinglai Tang
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  7. Danhui Yin
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  9. Gangcai Zhu
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Contributions

Conceptualization, GC Z and HM H; methodology, HM H and SY Z; formal analysis, HM H, XJ T; data curation, Q Y, DH Y; writing—original draft preparation, HM H and YX Q; writing—review and editing, GC Z; supervision, GC Z, QL T, SS L. All the authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Gangcai Zhu.

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It is not necessary for research ethics board approval and informed consent because cases were confirmed through Surveillance, Epidemiology, and End Results databases.

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Huang, H., Zeng, S., Tang, X. et al. The prognosis and treatment of newly diagnosed bone metastasis of head and neck squamous cell cancer: an analysis of racial disparity. Clin Transl Oncol 26, 966–976 (2024). https://doi.org/10.1007/s12094-023-03327-x

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