Association between treatment package time and clinical predictors in oropharyngeal cancer

Suzuki, Hitomi; Tamaki, Tsuneo; Tsuzuki, Hidenori; Nishio, Masami; Nishikawa, Daisuke; Beppu, Shintaro; Hanai, Nobuhiro

doi:10.1097/md.0000000000022244

Cited by 4 publications

(3 citation statements)

References 11 publications

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“…In light of the limitations of MDTBs, operational tools must be used to minimize the aforementioned delay and therefore TPT, defined as the amount of time between surgery and the last day of radiation [ 25 ]. A shorter TPT is important for patient outcomes, as a longer TPT has been linked with worse survival outcomes [ 26 ]. ICT can be utilized to help with data collection in the context of multi-disciplinary CC [ 27 ].…”

Section: Reviewmentioning

confidence: 99%

The Emerging Boon of Information and Communication Technology in Multidisciplinary Cancer Care: A Force Multiplier With a Human Touch

Vijayakumar¹,

Lancaster²,

Nittala³

et al. 2023

Cureus

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Cancer care (CC) is incredibly complex and requires the coordination of multiple disciplines for optimal outcomes. Historically, this has been accomplished with multidisciplinary tumor boards (MDTBs), but the benefits, while perhaps intuitive, have not always been demonstrated with sufficient research robustness and validity. We hypothesize that this difficulty in demonstrating the benefit of MDTBs may be related to a delay in decision-making and operationalizing those decisions. The history and value of MDTBs are presented as well as their weaknesses and limited demonstration of improved outcomes. A major weakness highlighted by the challenges of MDTBs is the concept of total package time (TPT) (rather, the inability to keep it as short as possible); any significant delays in CC for any discipline may have a deleterious impact on any given patient's care outcome. Drawing on our own experience with utilizing information and communication technology (ICT) during an effort to apply accountability theory to improve specifically radiation therapy package time (RTPT), we argue that similar principles will be applicable in the improvement of not only the TPT which relies on multiple disciplines, but other factors of CC as well, such as coordination. Experience with improvement in RTPT is discussed and the underlying theory is demonstrated as a sound methodology to apply beyond RTPT to TPT involving coordination of multiple disciplines and stands to lead to the full realization of the benefits of the multidisciplinary approach. The complexity of cancer means that real solutions to optimal outcomes are also, by nature, complex, but here simple accountability theory is demonstrated that may unlock the next phase of multidisciplinary coordination. In this work, we argue that the benefits of the MDTB format can be fully realized with the addition of ICT, a technological breakthrough in the past two decades, while not forgetting about continued human factors.

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Section: Reviewmentioning

confidence: 99%

The Emerging Boon of Information and Communication Technology in Multidisciplinary Cancer Care: A Force Multiplier With a Human Touch

Vijayakumar¹,

Lancaster²,

Nittala³

et al. 2023

Cureus

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“…Longer total treatment time has previously been demonstrated to be a predictor of worse overall survival in head and neck cancers, including OPSCC. 7,8 In particular, a longer interval between diagnosis and treatment initiation (T D-TI ) has been shown to be associated with shorter overall survival, and time cutoffs at 40 to 46 days and >67 days have been previously reported intervals associated with progressively worse outcomes. [9][10][11] Time from surgical resection and postoperative radiotherapy (T S-RT ) is also a significant factor in survival as delays may allow for proliferation of 1 microscopic residual tumor.…”

mentioning

confidence: 99%

“…In addition to type of treatment, the timing of care is essential and variations throughout the treatment course can impact prognosis. Longer total treatment time has previously been demonstrated to be a predictor of worse overall survival in head and neck cancers, including OPSCC 7,8 . In particular, a longer interval between diagnosis and treatment initiation (T D‐TI ) has been shown to be associated with shorter overall survival, and time cutoffs at 40 to 46 days and >67 days have been previously reported intervals associated with progressively worse outcomes 9‐11 .…”

mentioning

confidence: 99%

Treatment Delay and HPV Status on OPSCC With Upfront Surgery: Analysis of National Cancer Database

Vasudev,

Martin,

Frank

et al. 2024

Otolaryngol.--head neck surg.

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ObjectiveEvaluate the effect of treatment delay on survival in human papillomavirus (HPV)‐positive and HPV‐negative oropharyngeal squamous cell carcinoma (OPSCC) patients undergoing primary surgical resection.Study DesignRetrospective cohort study using the 2010‐2017 National Cancer Database.SettingMulticenter database study.MethodsPatients >18 years old with OPSCC and known HPV status, treated surgically with or without postoperative radiation/chemotherapy were included. Two cohorts based on HPV status were grouped by time to treatment initiation (TD‐TI, ≤30, 31‐60, ≥61 days) and surgery to radiotherapy (TS‐RT, ≤42, 43‐66, ≥67 days). Univariate, Kaplan‐Meier, and multivariate analyses assessed correlations between demographic and clinical factors with overall survival in treatment delay groups.ResultsIncluded were 1643 HPV‐positive OPSCC patients and 391 HPV‐negative OPSCC patients. No associations between survival and gender, age, race, insurance, or radiotherapy length were observed. Regardless of HPV status, larger tumor size (>2 cm) and lymphovascular invasion predicted worse survival. HPV negative patients with >4 lymph nodes involved had 2.5× greater mortality risk (P = .039). Robotic surgery was associated with improved survival only in HPV positive patients (hazard ratio [HR]: 0.41, P < .001). In HPV positive patients, higher TD‐TI related to lower mean survival, although this was not significant on multivariate analysis. HPV negative patients with >42 days of TS‐RT had decreased survival (43‐66 days, HR 1.63, P = .049; ≥67 days, HR 2.10, P = .032).ConclusionLonger TS‐RT was associated with lower overall survival in HPV negative patients. Treatment delay was not associated with survival in HPV positive OPSCC according to multivariate analysis. These findings enhance knowledge about treatment delay effects in OPSCC, aiding providers in decisions and patient communication.

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The effect of treatment package time on locally advanced oral cavity cancer outcomes

Petery,

Frankart,

Esslinger

et al. 2024

Oral Oncology

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Association between treatment package time and clinical predictors in oropharyngeal cancer

Cited by 4 publications

References 11 publications

The Emerging Boon of Information and Communication Technology in Multidisciplinary Cancer Care: A Force Multiplier With a Human Touch

The Emerging Boon of Information and Communication Technology in Multidisciplinary Cancer Care: A Force Multiplier With a Human Touch

Treatment Delay and HPV Status on OPSCC With Upfront Surgery: Analysis of National Cancer Database

The effect of treatment package time on locally advanced oral cavity cancer outcomes

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