scholarly journals Survival of patients with head and neck squamous cell carcinoma by housing subsidy in a tiered public housing system

Cancer ◽  
2017 ◽  
Vol 123 (11) ◽  
pp. 1998-2005 ◽  
Author(s):  
Ting Hway Wong ◽  
Thakshayeni Skanthakumar ◽  
Nivedita Nadkarni ◽  
Hai Van Nguyen ◽  
N. Gopalakrishna Iyer
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Public Housing ◽  
Squamous Cell ◽  
Neck Squamous Cell Carcinoma ◽  
Housing System ◽  
Housing Subsidy

scholarly journals Survival of Patients With Head and Neck Squamous Cell Carcinoma by Housing Subsidy in a Tiered Public Housing System

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 59s-59s
Author(s):  
T.H. Wong ◽  
T. Skanthakumar ◽  
N. Nadkarni ◽  
H.V. Nguyen ◽  
N.G. Iyer
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Public Housing ◽  
Squamous Cell ◽  
Advanced Disease ◽  
Neck Squamous Cell Carcinoma ◽  
Housing System ◽  
Housing Subsidy ◽  
Housing Type

Background: Socioeconomic status affects survival in patients diagnosed with head and neck squamous cell carcinoma (HNSCC), even in health systems with universal health care. Singapore has a tiered subsidized housing system, in which income determines eligibility for subsidies by size of apartment. Aim: The objective of this study was to assess whether a patient's residential type (heavily subsidized public housing, moderately subsidized public housing, minimally subsidized or private residential housing type) was associated with mortality. A secondary analysis examined whether patients in more heavily subsidized apartments were more likely to present with advanced disease. Methods: An historical cohort study of patients in a tertiary referral center with HNSCC was identified in the multidisciplinary cancer database from 1992 to 2014. Clinicopathologic data were extracted for analysis. Patient residential postal codes were matched to type of housing. Logistic regression was performed to evaluate the relationship between all-cause mortality and the predictors of interest as well as the association between housing type and disease stage at presentation. Results: Of the 758 patients identified, most were men (73.4%), the median age was 64 years, 30.5% were smokers and 15.2% were ex-smokers. Over one-half (56.8%) of patients presented with advanced disease. Male gender (OR 2.01, 95% CI 1.16-3.48, P = 0.01), age (OR 1.03, 95% CI 1.01-1.05, P < 0.001), stage at presentation (stage 4, reference stage 1, OR 2.03, 95% CI 1.11-3.72, P = 0.02), smoker status (smoker, reference nonsmoker, OR 2.53, 95% CI 1.33-4.87, P < 0.01) and housing subsidy type (living in minimally subsidized or private residences, relative to heavily subsidized public housing, OR 0.36, 95% CI 0.15-0.78, P = 0.01) were significantly associated with increased mortality. Kaplan-Meier curves showed that patients living in the smaller, higher subsidy apartments had the worst adjusted survival, followed by patients in moderately subsidized housing, with those in minimally subsidized or private residences having the best adjusted survival. Patients in higher-subsidy apartments were not more likely to present with advanced disease, suggesting that the survival difference was not because of delayed presentation. Conclusion: Patients with HNSCC living in higher-subsidy residences have worse survival despite no apparent delays in presentation. First published: Cancer. 2017 Jun 1;123(11):1998-2005. doi: 10.1002/cncr.30557 . Epub 2017 Jan 30. Survival of patients with head and neck squamous cell carcinoma by housing subsidy in a tiered public housing system. Wong TH, Skanthakumar T, Nadkarni N, Nguyen HV, Iyer NG.

Hubungan ekspresi p53, Bcl-2, c-Myc dan MMP-9 dengan gambaran klinikopatologi karsinoma sel skuamosa kepala-leher

2016 ◽  
Vol 46 (1) ◽  
pp. 53
Author(s):  
Azwar Azwar ◽  
Sofia Mubarika ◽  
Agus Surono
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Tumor Location ◽  
Neck Squamous Cell Carcinoma ◽  
Second Primary ◽  
Cross Sectional ◽  
P53 Expression ◽  
Local Metastasis

Latar belakang: Karsinoma sel skuamosa kepala dan leher merupakan salah satu kanker terseringdi seluruh dunia. Pendekatan pengobatan agresif dan multidisiplin telah dilakukan, namun belum adapeningkatan yang signifikan dalam kelangsungan hidup 5 tahun, selama 20 tahun terakhir. Kegagalanpengobatan terjadi dalam bentuk kekambuhan lokoregional, metastasis jauh, dan/atau tumor primer kedua.Berbagai penanda molekular tumor telah diteliti untuk mengetahui potensinya dalam memprediksi hasilpenyakit atau respon terhadap terapi.Tujuan: Mengetahui hubungan ekspresi protein p53, Bcl-2, c-Myc,dan MMP-9 berdasarkan gambaran klinikopatologis karsinoma sel skuamosa kepala dan leher di RumahSakit dr. Zainoel Abidin.Metode: Studi menggunakan desain cross sectional. Sampel terdiri dari 60blok parafin karsinoma sel skuamosa kepala dan leher. Prosedur pewarnaan imunohistokimia dilakukandengan menggunakan antibodi monoklonal terhadap p53, Bcl-2, c-Myc, dan MMP-9. Ekspresi proteinp53, Bcl-2, c-Myc, dan MMP-9 dianalisis secara imunohistokimia pada karsinoma sel skuamosa kepaladan leher kemudian hasilnya dihubungkan dengan parameter klinikopatologis seperti usia, jenis kelamin,lokasi tumor, diferensiasi tumor, metastasis kelenjar getah bening dan stadium tumor, kemudian dianalisisstatistik dengan Chi square.Hasil: Hasil penelitian menunjukkan terdapat hubungan bermakna tingkatekspresi p53 dengan metastasis lokal (p=0,021) dan ada hubungan bermakna tingkat ekspresi MMP-9dengan lokasi tumor (p=0,026). Tidak terdapat hubungan ekspresi p53, Bcl-2, cMyc, dan MMP-9 terhadapusia, jenis kelamin, stadium tumor, diferensiasi histologi, tingkat T, N, dan metastasis jauh.Kesimpulan:Ada hubungan ekpresi p53 dengan metastasis kelenjar limfe regional dan ekspresi MMP-9 dengan lokasitumor pada karsinoma sel skuamosa kepala dan leher. Kata kunci: Karsinoma sel skuamosa kepala dan leher, p53, Bcl-2, c-Myc, MMP-9 ABSTRACTBackground: Head and neck squamous cell carcinoma (HNSCC) is one of the most commoncancers world wide. Although aggressive and multidisciplinary approach to the treatment has been done,there is no significant improvement in 5-year survival in the last 20 years. Treatment failure occurredin the form of locoregional recurrence, distant metastasis, and/or a second primary tumor. A variety oftumor molecular markers have been studied to determine their potential in predicting disease outcome orresponse to the therapy. Purpose: To investigate correlation p53, Bcl-2, c-Myc, and MMP-9 expressionto clinicopathologic parameter in head and neck squamous cell carcinoma patient in dr. Zainoel Abidinhospital. Methods: Cross sectional design study. The sample was consisted of 60 paraffin blocks ofhead and neck squamous cell carcinoma. Procedure of immunohistochemical staining used monoclonalantibodies against p53, Bcl-2, c-Myc, and MMP-9. Expression of p53 protein, Bcl-2, c-Myc, and MMP-9were analyzed by immunohistochemistry in head and neck squamous cell carcinoma. Then, the results were linked to clinicopathologic parameters such as age, sex, tumor location, tumor differentiation,lymph node metastasis and tumor stage, and statistically analyzed with Chi square. Results: The resultsshowed there were significant correlation between p53 expression level with local metastasis (p=0,021)and significant correlation of MMP-9 expression levels with tumor location (p=0,026). There were norelationship of p53, Bcl-2, cMyc and MMP-9 expressions based on age, sex, stage tumor, histologicdifferentiation, level of T, N, and distant metastases. Conclusion: There were relationships between p53expression with local metastasis and MMP-9 expression with tumor location in head and neck squamouscell carcinoma. Keywords: Head and neck squamous cell carcinoma, p53, Bcl-2, c-Myc, MMP-9

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