{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T20:42:15Z","timestamp":1779914535557,"version":"3.53.1"},"reference-count":36,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T00:00:00Z","timestamp":1671753600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>To evaluate treatment modalities of T4 larynx cancer in older adults using SEER\u2010Medicare.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The database was queried for patients aged 66 and older with nonmetastatic T4 laryngeal squamous cell cancer from 2006 to 2015. Treatment modalities compared were surgery plus chemoradiation (SCR), surgery plus radiation (SR), chemoradiation (CR), surgery (S), and radiation (R). Multivariate analysis and Kaplan\u2013Meier methods were used to explore the relationship of treatment modality and survival. Total cancer\u2010related costs were calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 438 patients met inclusion criteria. Patients receiving CR or SR had similar CSS to SCR (HR 1.36 and HR 1.24, respectively). Those receiving S (HR 2.00) or R (HR 2.41) had significantly worse CSS. Similar findings were observed for OS. Cancer care\u2010related costs were not significantly different but highest in SCR ($162215) and lowest in R ($121421).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Older patients with T4 larynx cancer had similar survival rates when treated with CR, SR, and SCR. Average total health care costs were not significantly different between modalities. Patients not eligible for triple\u2010modality could consider these other treatment options.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hed.27284","type":"journal-article","created":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T20:19:41Z","timestamp":1671826781000},"page":"664-674","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Treatment outcomes and cost comparisons for older adults with <scp>T4<\/scp> laryngeal squamous cell cancer"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3667-566X","authenticated-orcid":false,"given":"Jessica D.","family":"McDermott","sequence":"first","affiliation":[{"name":"Department of Medical Oncology University of Colorado Anschutz School of Medicine  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8311-9159","authenticated-orcid":false,"given":"Arya","family":"Amini","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology City of Hope  Duarte California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Molina","sequence":"additional","affiliation":[{"name":"Department of Health Systems, Management, and Policy University of Colorado Anschutz Medical Campus  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William A.","family":"Stokes","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Emory University  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sana D.","family":"Karam","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Colorado Anschutz School of Medicine  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,12,23]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"AJCC Cancer Staging Manual, Eighth Edition","author":"AJCC","year":"2017"},{"key":"e_1_2_8_3_1","unstructured":"National Comprehensive Cancer Network.NCCN guidelines for head and neck cancer care.https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/head-and-neck.pdf."},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2014.1671"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/1460-6984.12148"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199106133242402"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21081"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mds065"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.43.6097"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2011.05.036"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.75.7385"},{"issue":"4","key":"e_1_2_8_12_1","first-page":"1400","article-title":"T4 laryngeal cancer with good function: Should we be reluctant to treat without surgery?","volume":"102","author":"Beitler JJ","year":"2018","journal-title":"Head Neck Cancer"},{"key":"e_1_2_8_13_1","unstructured":"https\/\/healthcaredelivery.cancer.gov\/seermedicare\/overview\/. 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