Abstract
e18024 Background: Adenocarcinoma in Villous Adenoma (AVA) is a metastatic disease that arises from villous adenomas. These adenocarcinomas can arise from different tissues, particularly this analysis looked at AVA arising from the head and neck region. Treatment for otolaryngological AVA varied depending on grade, but the majority of patients received surgery or radiation. Despite its rarity, 16.7% of patients pass within 90 days after receiving surgery for this cancer. Given the rarity, data analysis of demographic findings could provide important information regarding its occurrence and distribution in the population. Methods: Patients from the National Cancer Database (NCDB) with a confirmed diagnosis of otolaryngological AVA from 2004–2017 were used in a retrospective cohort analysis (N = 33). Factors analyzed by descriptive statistics and regression analysis include sex, race, average household income, Charlson-Deyo score, palliative care obtained, and year of diagnosis. Results: A total of 33 patients were identified in the database with a confirmed diagnosis of AVA in the head and neck between 2004 – 2017 with a steady incidence of patients diagnosed per year (R2 = 0.0). The average age of diagnosis was 69 years (SD = 9.7, range = 51-85 years). The top primary site was the esophagus (90.9%). Most individuals (60.6%) had Charlson/Deyo comorbidity scores of 0. The majority of the patients were Non-Hispanic and White (97.0%). There was an equal distribution of income earners in the first and second quartile (33.3% and 33.3%) compared to those in the third or fourth quartiles (upper and middle quartiles are defined as over $74,063 and $57,857 to $74,062, respectively). A higher percentage of patients were insured by Medicare (57.0%) or privately insured (36.4%), compared to those who were uninsured. Most patients lived in metropolitan counties with a population greater than 1 million (51.6%). The majority of patients were treated in a comprehensive community cancer program (54.5%). Most patients did not receive palliative care (97.0%) and 16.7% of patients died within 90 days of receiving surgical treatment. Conclusions: With most data showing extensive data analysis on AVA stemming from the colon, this is the only analysis of demographic data from this cancer originating from the head and neck region. From the NCDB data, the majority of patients are non-Hispanic and White with a primary-site diagnosis presenting in the esophagus. This is the first time that specific AVA socio-economic data has been analyzed: patients with this cancer tend to be in upper or middle income brackets, live in crowded metropolitan areas, and have Medicare as their insurance coverage. To further our understanding of otolaryngological AVA, it would be necessary to examine the relationship between demographic and socioeconomic factors, and the diagnosis, treatment options, and survival rates for individuals with AVA.