Department of Otolaryngology - Head & Neck Surgery, University of Rochester Medical Center, Rochester, New York, USA.
School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, New York, USA.
Head Neck. 2022 Feb;44(2):472-482. doi: 10.1002/hed.26945. Epub 2021 Nov 29.
To examine the association between distance to care-center and urban-rural residence on 5-year overall survival (OS) from head and neck cancer (HNC).
Five-year OS was retrospectively measured from date of initial diagnosis for patients with HNC treated at a single tertiary care center. Distances were calculated based on ZIP code of patient's residence and care center. Multilevel Weibull regression was used to adjust for confounders and identify disparities in 5-year all-cause mortality.
A total of 670 patients included in study. Multivariable analysis revealed older age or late-stage cancer at diagnosis, and HPV negative status were associated with poorer OS. Patients residing in isolated small rural town (HR = 2.20, p = 0.015) or small rural town (HR = 2.07, p = 0.015) had lower OS. Distance to care center was not associated with OS (HR = 0.996, p = 0.11).
Greater rurality was associated with poorer OS among HNC patients in Upstate New York.
研究距离治疗中心的远近与城乡居住情况对头颈部癌症（HNC）患者 5 年总生存率（OS）的影响。
回顾性测量了在单一三级护理中心接受治疗的 HNC 患者从初始诊断日期起的 5 年 OS。距离根据患者居住地和护理中心的邮政编码计算。采用多级威布尔回归来调整混杂因素，并确定 5 年全因死亡率的差异。
共有 670 名患者纳入研究。多变量分析显示，年龄较大或诊断时癌症晚期以及 HPV 阴性状态与较差的 OS 相关。居住在偏远的小型农村城镇（HR=2.20，p=0.015）或小型农村城镇（HR=2.07，p=0.015）的患者 OS 较低。距离治疗中心的远近与 OS 无关（HR=0.996，p=0.11）。
在纽约州北部，农村地区的癌症患者 5 年生存率较低。
