Abstract 3472: Does being married independently predict survival in patients with head and neck cancer? Results from a single institution
Authors: Osazuwa-Peters Nosayaba , Christopher Kara M. , Massa Sean T. , Cass Lauren , Walker Ronald J. , Varvares Mark A. 
Published: July 2016

Abstract
Purpose/Objectives
An important factor in cancer survivorship is social support, often coming from a spouse. There is an emerging literature on the role of spousal support in head and neck cancer (HNC) outcomes; however most are based on results from national databases. While more generalizable, these studies may not always capture the unique variation in different patient populations. This single institution study aimed to describe the association between marital status and outcomes of HNC; and to determine if marital status independently predicts survival in a local patient population.
Materials/Methods
We identified 460 patients aged 20 to 91 (59.31 ± 11.42) years diagnosed with squamous cell carcinoma of the head and neck at an academic tertiary referral center between 1997 and 2012 in this retrospective cohort study. Cox proportional hazards model assessed the effect of marital status on survival. Results are based on the final model constructed after accounting for covariates in the data.
Results
Our study population was made up of 73% males, and 82.2% Whites. We found an association between marital status and HNC survival. Unmarried HNC patients had a 66% increase in the hazard of death compared to married HNC patients (HR = 1.66, 95% CI = 1.23 - 2.23). This was after controlling for covariates, which included sociodemographic variables (age, race, sex, and health insurance status), social habits (tobacco and alcohol), primary anatomical subsite (oral cavity, oropharyngeal, laryngeal, and others), stage at presentation (early vs. late stage), and treatment modality (surgery, surgery with adjuvant therapies, other single modality therapy, and palliative care). Other factors found to be associated with an increased hazard of death were age (≥ 50 years), current tobacco use, late stage of presentation, palliative care, and laryngeal subsite.
Conclusion
Marital status is associated with head and neck cancer outcomes, and being married is an independent predictor of survival among patients. This result, found in previous national studies, held true in our local patient population. This underscores the need for the multidisciplinary HNC team to recognize this aspect of survivorship and to emphasize the need for social support among unmarried HNC patients. It could be that it is necessary to add social support to the clinical practical guidelines for managing head and neck cancer beyond palliative care.
Citation Format: Nosayaba Osazuwa-Peters, Kara M. Christopher, Sean T. Massa, Lauren Cass, Ronald J. Walker, Mark A. Varvares. Does being married independently predict survival in patients with head and neck cancer? Results from a single institution. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 3472.