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Background: Laryngectomy is a pivotal event in patients. lives, with pervasive and far-reaching effects. Understanding gender differences in these effects may improve care of laryngectomy patients. This paper describes gender differences in the experience after laryngectomy. Aim: To explore the similarities and differences in the laryngectomee experience based on gender. Methods & Procedures: Four gender-matched focus groups were conducted; dialogue was audio recorded, transcribed and studied using interpretative phenomenological analysis (IPA). Outcomes & Results: A total of 17 laryngectomees, eight female and nine male, age range 41-80 years, participated in focus groups. Laryngectomy represented a turning point in the lives of both genders. Four themes emerged: perception of loss, adjusting to alaryngeal communication, finding a positive outlook and re-establishing the self. Themes applied to both genders, with subthemes demonstrating similarities and differences between men and women. Conclusions & Implications: Men and women experienced destabilization after laryngectomy related to perceived losses and shifts in identity. Men described navigating from physical disability toward recovery of function, while women described an emotional journey concerning loss and rediscovery of meaning in their lives. Understanding the laryngectomee experience in better detail, which includes recognizing gender differences and rejecting a one-size-fits-all approach, may facilitate more effective preoperative counselling and post-operative support from providers.

Objectives: Lymphoma, categorized as either non-Hodgkin's lymphoma or Hodgkin's lymphoma, is the second most common malignancy in the head and neck. Primary tongue lymphoma is exceedingly rare, with only case reports or small case series in the literature. This population-based analysis is the first to report the epidemiology and prognostic factors of survival in patients with primary tongue lymphoma. Methods: The Surveillance, Epidemiology, and End Results 18 database from the National Cancer Institute was queried for patients diagnosed between the years 2000 and 2016 with tongue lymphoma. Outcomes of interest were overall and disease-specific survival. Independent variables included age at diagnosis, sex, race, marital status, primary subsite, histologic subtype, stage, and treatment type. Results and Conclusion: Seven hundred forty patients met criteria; the male-female ratio was 1.5:1 and the mean age at diagnosis was 67.8 years. The majority of lesions localized to the base of tongue (90.0%), were histologically diffuse large B-cell lymphoma (59.5%), and presented at stage I or II (77.9%). Most early-stage lymphomas were treated with chemotherapy only (40.5%) or a combination of both chemotherapy and radiation (31.3%), while late-stage cancers were primarily treated with chemotherapy alone (68.5%). In multivariate analysis, younger age at diagnosis, female sex, married/partnered marital status, mucosa-associated lymphoid tissue histologic subtype, and earlier cancer stage were found to be associated with improved survival. Chemotherapy treatment with or without radiation was also associated with better survival compared to no treatment or radiation alone, though data regarding immunotherapy was unavailable. [ABSTRACT FROM AUTHOR]

Objectives/Hypothesis: Radiation‐associated sarcomas of the head and neck (RASHN) are known but rare sequelae after radiation for squamous cell carcinoma. The purpose of this study was to characterize RASHN, estimate the risk of RASHN in head and neck squamous cell patients after therapeutic radiation, and compare their survival to that of patients with de novo sarcomas of the head and neck (dnSHN). Study Design: Retrospective database analysis. Methods: RASHN and dnSHN cases were collected from the Surveillance, Epidemiology, and End Results Database to identify risk factors and calculate incidence and latency. Survival was compared between RASHN and dnSHN. Results: The risk of RASHN was 20.0 per 100,000 person‐years. The average latency period was 124.2 months (range 38–329). The cumulative incidence of RASHN at 20 years was 0.13%. Oral cavity and oropharynx primaries demonstrate increased risk. Five‐year overall survival of RASHN was 22.4% compared to 64.5% for dnSHN. Conclusions: RASHN are confirmed to be rare. RASHN have poor overall survival and worse survival compared to dnSHN. The impact of intensity‐modulated radiation therapy protocols on this risk is unknown. Modifiable risk factors of smoking and alcohol consumption continue to dwarf radiation therapy as risk factors of second primary head and neck cancers. Level of Evidence: 3 Laryngoscope, 132:1034–1041, 2022 [ABSTRACT FROM AUTHOR]

Objectives/Hypothesis: Subglottic squamous cell carcinoma (SSCC) is a rare cancer with limited evidence‐based treatment guidelines. This study aimed to describe the treatment patterns for SSCC and to determine which treatments provide the best overall survival. Study Design: Retrospective database review. Methods: The National Cancer Database (NCDB) was queried for patients treated for SSCC from 2004 through 2014. Overall survival (OS) rates were determined by the Kaplan‐Meier method. Clinicopathologic characteristics were assessed by univariable and multivariable Cox proportional hazards models, which corrected for age, sex, race, insurance status, income quartile, residence, Charlson‐Deyo comorbidity score, facility type providing treatment, tumor grade, and clinical N and T category. Results: In this cohort of 549 patients with SSCC, the 5‐year OS was 48.2%. SSCC presented at an advanced stage (American Joint Committee on Cancer stage III or IV) in 60.1% of cases; 78.3% of cases had no nodal metastases. Among only stage IV cases, multivariable analysis showed that radiotherapy (RT) (hazard ratio [HR] = 5.944; 95% confidence interval [CI]: 2.76‐12.8; P <.001) and chemoradiotherapy (CRT) (HR = 2.321; 95% CI: 1.36‐3.97; P =.002) were both associated with decreased 5‐year OS compared to a group consisting of all surgeries. When this analysis was repeated for only stage III cases, RT (HR = 1.134; 95% CI: 0.38‐3.37; P =.821) and CRT (HR = 1.784; 95% CI: 0.78‐4.08; P =.170) were equivalent to surgery. Conclusions: Using the NCDB to study the largest cohort of SSCC with known staging and treatment, primary surgery may provide a better 5‐year OS in advanced‐stage SSCC. Level of Evidence: 4 Laryngoscope, 131:E1117–E1124, 2021 [ABSTRACT FROM AUTHOR]

Objective: To determine if there are differences in mortality from oral cavity squamous cell carcinoma (OCSCC) based on oral cavity (OC) subsites.Methods: Using the Surveillance, Epidemiology, and End Results Program (SEER) 9 database, patients with sequence number 0 or 1 squamous cell OCSCC were analyzed by OC subsite for 5-year cause-specific mortality (CSM) from OCSCC. Proportional hazards regression determined the association between 5-year CSM and OC subsites while controlling for treatment modality, stage, and demographic characteristics using hazard ratios. Significance was set at alpha = 0.05.Results: 20,647 OC patients were included in the regression analysis. The most commonly diagnosed sites were floor of mouth (34.4%) and oral tongue (34.3%). Floor of mouth, upper gum, and retromolar trigone were associated with lower CSM compared to oral tongue. Not receiving surgery and receiving radiation were associated with increased CSM, and CSM increased with cancer staging when distant or regional disease was compared to localized disease. Also, patients diagnosed at 60 years or older and black patients had increased CSM.Conclusion: Among OCSCC patients, those with oral tongue cancer are more likely to experience CSM than patients with floor of mouth, upper gum, and retromolar trigone cancer. It is important to understand these mortality related differences in the management of OCSCC patients. Understanding subsite-specific mortality may benefit prognosis counseling of OCSCC patients and elicit subsite-directed research as a means to improve outcomes.Level Of Evidence: NA Laryngoscope, 129:1400-1406, 2019. [ABSTRACT FROM AUTHOR]

Importance: Head and neck cancer (HNC) is more common among socioeconomically disenfranchised individuals, making financial burden particularly relevant., Objective: To assess the financial burdens of HNC compared with other cancers., Design, Setting, and Participants: In this retrospective review of nationally representative, publicly available survey, data from the Medical Expenditure Panel Survey were extracted from January 1, 1998, to December 31, 2015. A total of 444 867 adults were surveyed, which extrapolates to a population of 221 503 108 based on the weighted survey design. Data analysis was performed from April 18, 2018, to August 20, 2018., Exposures: Of 16 771 patients with cancer surveyed (weighted count of 10 083 586 patients), 489 reported HNC (weighted count of 261 631)., Main Outcomes and Measures: Patients with HNC were compared with patients with other cancers on demographics, income, employment, and health. Within the HNC group, risk factors for total medical expenses and relative out-of-pocket expenses were assessed with regression modeling. Complex sampling methods were accounted for with weighting using balanced repeated replication., Results: A total of 16 771 patients (mean [SD] age, 62.3 [18.9] years; 9006 [53.7%] female) with cancer were studied. Compared with patients with other cancers, patients with HNC were more often members of a minority race/ethnicity, male, poor, publicly insured, and less educated, with lower general and mental health status. Median annual medical expenses ($8384 vs $5978; difference, $2406; 95% CI, $795-$4017) and relative out-of-pocket expenses (3.93% vs 3.07%; difference, 0.86%; 95% CI, 0.06%-1.66%) were higher for patients with HNC than for patients with other cancers. Among patients with HNC, median expenses were lower for Asian individuals compared with white individuals ($5359 vs $10 078; difference, $4719; 95% CI, $1481-$7956]), Westerners ($8094) and Midwesterners ($5656) compared with Northwesterners ($10 549), and those with better health status ($16 990 for those with poor health vs $6714 for those with excellent health). Higher relative out-of-pocket expenses were associated with unemployment (5.13% for employed patients vs 2.35% for unemployed patients; difference, 2.78%; 95% CI, 0.6%-4.95%), public insurance (5.35% for those with public insurance vs 2.87% for those with private insurance; difference, 2.48%; 95% CI, -0.6% to 5.55%), poverty (13.07% for poor patients vs 2.06% for high-income patients), and lower health status (10.2% for those with poor health vs 1.58% for those with excellent health)., Conclusions and Relevance: According to this study, HNC adds a substantial, additional burden to an already financially strained population in the form of higher total and relative expenses. The financial strain on individuals, assessed as relative out-of-pocket expenses, appears to be driven more by income than by health factors, and health insurance does not appear to be protective.