Background: In recent years, socioeconomic factors have been found to have a profound impact on health outcomes in the realm of head and neck cancer. In this study, we sought to understand the impact of demographic and socioeconomic factors on adjuvant treatment and survival outcomes in patients with early-stage, oral tongue squamous cell carcinoma (OSCC).
Methods: We conducted a retrospective review of the National Cancer Database (NCDB) for patients with primary, early stage (cT1-T2, N0) oral tongue SCC from 2004 to 2017. We performed univariable and multivariable logistic regression to identify patient or tumor factors associated with the need for postoperative adjuvant radiation or chemotherapy. We also analyzed overall survival (OS) via Cox proportional hazard analyses.
Results: There were 13 220 patients included in the analysis. On multivariable analysis, factors associated with an increased likelihood of adjuvant treatment included younger age, shorter distance to the patient's treatment center, Hispanic ethnicity, and urban location. Adherence to radiation treatment was less likely (p < 0.05) in patients who were older age, male sex, rural geography, and those with Medicare insurance. OS was worse for patients who were older age, Charlson-Deyo Score > 0, had nonprivate insurance, and residing in an urban geography.
Conclusion: This study evaluates the impact of demographic and socioeconomic factors on those treated for oral tongue SCC, while controlling for tumor stage at presentation. Ethnicity, geography, and insurance status play a role in the need for adjuvant therapy and OS. These factors warrant further exploration in the interplay with long-term outcomes in patients with head and neck cancer.
Keywords: adjuvant treatment; oral squamous cell carcinoma; overall survival; socioeconomic; t stage.
© 2025 The Author(s). Head & Neck published by Wiley Periodicals LLC.