Association between treatment delays and oncologic outcome in patients treated with surgery and radiotherapy for head and neck cancer

Association between treatment delays and oncologic outcome in patients treated with surgery and radiotherapy for head and neck cancer HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK Tumati, V., Hoang, L., Sumer, B. D., Truelson, J. M., Myers, L. L., Khan, S., Hughes, R. S., Nedzi, L., Sher, D. J. 2019; 41 (2): 315-321

Abstract

This study sought to determine the oncologic impact of delays to surgery, radiotherapy, and completion of therapy in patients with head and neck squamous cell carcinoma.The impact of biopsy to surgery (BTS) time, surgery to start of radiation time (STSR), and radiation treatment time (RTT) on locoregional recurrence (LRR), distant metastases (DMs), and cancer-specific mortality (CSM) was examined. The cumulative incidences (CI) of LRR, DMs, and CSM were examined using Fine-Gray testing.A total of 277 patients treated with surgery and adjuvant radiotherapy were analyzed. On multivariable testing, BTS >50?days was associated with DM (P?=?.03), whereas RTT and STSR were not. RTT >43?days was associated with LRR (P?=?.02) in patients with non-p16-positive-oropharynx cancer.An increase in DM appears to be the mechanism by which prolonged time to treatment initiation leads to worse overall survival. Prolonged RTT has the greatest impact on patients with non-p16 positive oropharynx cancers.

View details for DOI 10.1002/hed.25457

View details for Web of Science ID 000457416500010

View details for PubMedID 30548892