Premium
Treatment delays in oral cavity squamous cell carcinoma and association with survival
Author(s) -
Fujiwara Rance J. T.,
Judson Benjamin L.,
Yarbrough Wendell G.,
Husain Zain,
Mehra Saral
Publication year - 2017
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.24608
Subject(s) - medicine , proportional hazards model , logistic regression , medicaid , basal cell , comorbidity , hazard ratio , head and neck squamous cell carcinoma , cancer , head and neck cancer , radiation therapy , duration (music) , oncology , surgery , art , confidence interval , health care , literature , economics , economic growth
Background Treatment durations and factors associated with delays for oral cavity squamous cell carcinoma (SCC) have previously been described but are not fully understood. Impact of delays on overall survival (OS) remains unclear. Methods The National Cancer Data Base (NCDB) was used to analyze 4868 patients with oral cavity SCC from 1998 to 2011. Diagnosis‐to‐surgery, surgery‐to‐radiotherapy (RT) start , RT duration, total treatment package (surgery‐to‐RT end ), and diagnosis‐to‐RT end were evaluated. Associations between delays and various factors were analyzed using binary logistic regression. Associations with OS were analyzed using the Cox proportional hazards model. Results Medians for diagnosis‐to‐surgery, surgery‐to‐RT start , RT duration, total treatment package, and diagnosis‐to‐RT end were 30, 50, 49, 101, and 136 days, respectively. Age ≥60 years, uninsured or Medicaid insurance, comorbidity, late pT, and treatment at an academic/research institution were associated with diagnosis‐to‐surgery delays. Only delays in RT duration were significantly associated with decreased OS (hazard ratio [HR] = 1.21; p = .02). Conclusion Numerous factors are associated with treatment delays. RT duration is significantly associated with OS. © 2017 Wiley Periodicals, Inc. Head Neck 39: 639–646, 2017