Abstract 4926: African American patients with stage III laryngeal squamous cell carcinoma have poorer survival despite similar definitive treatment and follow-up care

Background: Laryngeal squamous cell carcinoma (LSCC) represents a significant subset of head and neck squamous cell carcinomas (HNSCC), contributing to substantial morbidity and mortality. While disparities in outcomes and care delivery for HNSCC and LSCC have been documented, there is a lack of contemporary literature exploring these disparities in the modern era of widespread chemoradiation therapy and advancements in radiation therapy (RT), chemotherapy, and supportive care. Methods: We conducted a retrospective review of our single-institution database, identifying patients diagnosed with LSCC between January 1, 2014, and December 31, 2022. The study focused on assessing disparities in care and outcomes between African American (AA) and European American (EA) patient populations. Patients were staged according to the AJCC 8th edition criteria. Results: Data from 251 patients with LSCC were analyzed. Focus on subgroup analysis of AA and EA ancestries (n=202) revealed a higher incidence among AA women (35% vs. 22% in EA), similar smoking rates in both groups (>94%), and a higher incidence of government insurance (Medicare/Medicaid) among AA patients(85% vs. 75% in EA). Compared to EA patients, AA patients presented with higher Stage IV disease (43% vs. 32%), predominantly due to higher rates of T4 tumors (18% vs. 9%) and more frequent N2 nodal involvement (29% vs. 21%). Rates of distant metastases at presentation were low in both groups (3.1% in EA and 3.8% in AA). For patients with Stage III/IV disease, the majority (90%) received combined modality chemoradiation therapy, with a median definitive RT dose of 7,000 cGy delivered in both populations (p=0.52). Upfront or salvage laryngectomy rates for Stage IV non-metastatic disease were similar between AA and EA patients (20%(AA) vs. 19% (EA)). Stage-specific overall survival (OS) analysis demonstrated significantly poorer survival for AA patients with Stage III LSCC (median OS = 30 months) compared to EA patients (median OS = 95 months) (p=0.01; hazard ratio [HR] 2.741, 95% confidence interval [CI] 1.229-6.116), despite similar median follow-up times for surviving patients (AA mean = 67 months [95% CI 56-79 months]; EA mean = 65 months [95% CI 54-77 months]; p=0.81). This difference in survival was not observed in Stage I, II, IV, or stage-agnostic analyses. Conclusion: AA patients with Stage III LSCC exhibit significantly poorer survival compared to EA patients, despite receiving similar definitive treatment and follow-up care. These findings suggest that biological factors may contribute to outcome disparities beyond socioeconomic factors, highlighting the need for further research into underlying mechanisms and the development of tailored interventions. Citation Format: Pranay Adavelly, Helen Gandler, Jessica Bauman, Jeremy Price, Curtis Miyamoto, Parth Anil Desai. African American patients with stage III laryngeal squamous cell carcinoma have poorer survival despite similar definitive treatment and follow-up care [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4926.