Determinants of treatment waiting times for head and neck cancer in the Netherlands and their relation to survival

Harten, Michel C. van; Hoebers, Frank; Kross, Kenneth W.; Werkhoven, Erik van; Brekel, Michiel W. M. van den; Dijk, Boukje A. C. van

doi:10.1016/j.oraloncology.2014.12.003

Cited by 160 publications

(186 citation statements)

References 26 publications

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“…In an attempt to preserve healthcare resources by cutting or time for surgeons, the healthcare system may be putting patients at risk for poorer outcomes. These findings are consistent with those of Van Harten et al 7 , who reported a causal relationship between delays to treatment and higher patient mortality in a similar patient population. We observed that individuals "exposed" to months with less than average or hours were at higher risk of cancer recurrence and trended toward higher mortality.…”

Section: Discussionsupporting

confidence: 93%

“…A landmark investigation by Van Harten et al 7 in the Netherlands showed that longer wait times for head and neck cancer surgery were associated with a higher risk of death; the hazard of dying increased by 7% for each week waited for treatment. Longer wait times for cancer surgery put patients not only at risk of increased morbidity due to larger resections secondary to tumour progression 7 , but also at increased risk of mortality. Thus, strategies to ensure prompt treatment are crucial to obtain optimal patient outcomes.…”

Section: Introductionmentioning

confidence: 99%

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The Impact of Seasonal Operating Room Closures on Wait Times for Oral Cancer Surgery

et al. 2018

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

The Impact of Seasonal Operating Room Closures on Wait Times for Oral Cancer Surgery

et al. 2018

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“…Multivariable Cox regression showed that longer waiting time (>30 days) was related to a higher hazard of dying (p<0.0001). They concluded that a longer waiting time is a significant negative prognostic factor (28).…”

Section: Discussionmentioning

confidence: 99%

Impact of Time Factors on Outcome in Patients with Head and Neck Cancer Treated with Definitive Radio(Chemo)Therapy

Dahlke

Steinmann

Christiansen

et al. 2018

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Abstract. Aim: To evaluate treatment-related factors such as overall treatment time (OTT) and radiation treatment time (RTT) in head-and-neck cancer. Patients and MethodsSquamous cell carcinoma of the head and neck (SCCHN) is a cancer with worldwide impact. Oral cavity cancer as subgroup of SCCHN for instance accounts for approximately 300,400 new cases and 145,400 deaths every year (1). Most of these cases, approximately 90%, are SCCs. The most important risk factors in that etiology are tobacco and alcohol consumption, followed by other risk factors such as human papilloma virus infection, dietary factors and genetic susceptibility (2). Small SCCHN without lymphatic involvement can be cured in 70-90% of cases with either surgery or radiotherapy alone (3). For locally advanced SCCHN i.e. stage III or IV, surgery, radiotherapy and chemotherapy are the main treatment modalities for curative management. However, local and distant failure rates remain high despite intensified and combination therapy (4). If surgery is not possible due to co-morbidities or is refused due to potential loss of organ function, definitive radiotherapy with or without chemotherapy or targeted therapy e.g. cetuximab can be applied as a curative approach (5). The combination of therapies has shown to be superior in comparison to radiotherapy alone in several randomized studies and meta-analysis regarding overall survival and local control (4, 6,7).Up to 40% of patients treated for head and neck cancer develop a recurrence within 5 years after treatment. Reirradiation should definitely be considered for patients with a recurrent or second primary head and neck cancer (8). Therefore, improved local control is likely to lead to improved disease-free and overall survival (OS) (9). There are different prognostic treatment factors with impact on the further course of disease such as simultaneous application of chemotherapy or targeted therapy and total dose, dose per fraction or fractions per day/per week (10, 11). As well as these established factors, there may be other treatment-related factors with influence on further outcome, such as treatment time. In other cancer types, a prolonged overall treatment time (OTT) had a negative impact on survival (12). The influence of time as a factor may also become more important in countries with an imbalance between increased demand and availability of radiotherapy treatment units (13). Therefore, in addition to established prognostic factors, we analyzed the influence of different time periods influencing the OTT on further outcome of disease in patients with locally advanced SCCHN in terms of locoregional recurrence-free survival (LRFS), metastasis-free survival (MFS) and OS. 949This article is freely accessible online.Correspondence to: Sören Dahlke,

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“…In lung cancer, the median time from diagnosis to radiotherapy was 6 weeks, but it was 16 weeks for breast and colorectal cancers [13]. A Dutch study [5] found that the median waiting time of patients with head and neck tumours between histopathological testing to the onset of treatment was 37 days.…”

Section: Discussionmentioning

confidence: 99%

“…The effectiveness of a given cancer therapy is most probably affected by waiting time as variously supported by published studies, although conclusions have not always been unequivocal. A Dutch study [5] found that prolonging waiting time of up to 3 months after a diagnosis of head and neck head cancer reduced 5 year overall survival by 18% and significantly increased mortality risk after 2 months from diagnosis. A meta-analyses showed similar findings [6], where prolonged waiting times for treatment from the first signs of breast cancer (< 3 vs 3-6 months) reduced the 5-year survival by 5-7%.…”

Section: Introductionmentioning

confidence: 99%

Have actual waiting times been reduced by introducing the DILO reform for cancer patients in Poland?

Osowiecka

Rucińska²,

Nawrocki³

2017

Nowotwory. Journal of Oncology

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Introduction.Relative 5-year cancer survival rates in Poland are around 10% lower than the average of the whole EU. One of the likely factors for poorer treatment outcomes in Poland may be the long times between when cancer is suspected to starting treatment. This study has thus aimed to determine whether the introduced oncology reforms have succeeded in reducing such times. Materials and methods. The study survey was undertaken at 6 oncological centres on patient subjects before (n = 1373) and after (n = 431) the oncological reform (DILO) had been introduced. Data was obtained from an inhouse devised questionnaire together with patient interview and their medical history. The following waiting times were estimated: A) from suspicion of cancer, (date of first doctor visit due to appearance of symptoms, screening/ /follow-up or prevention), to diagnosis (date of histopathological confirmation), B) from suspicion of cancer to the start of treatment and C) from diagnosis to starting treatment before and after the DILO reform had been introduced. Results. The median waiting time between suspicion of cancer and treatment was 11 weeks before the DILO reform but was not significantly shortened after its introduction; the reduction being barely 3 days. This waiting time was however increased by 8 days in those patients without DILO cards. Before the DILO reform, the median time from diagnosis was 5.9 weeks, but was reduced by 8 days in patients bearing the DILO card and indeed increased in those without the DILO card by over 2 weeks. Conclusions. Cancer treatment waiting times in Poland is still somewhat long (over 9 weeks in most cases). Introducing the oncological reform has not significantly impacted on shortening the waiting times in cancer patients for receiving oncological treatment. NOWOTWORY J Oncol 2017; 67, 3: 168-173

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Determinants of treatment waiting times for head and neck cancer in the Netherlands and their relation to survival

Cited by 160 publications

References 26 publications

The Impact of Seasonal Operating Room Closures on Wait Times for Oral Cancer Surgery

The Impact of Seasonal Operating Room Closures on Wait Times for Oral Cancer Surgery

Impact of Time Factors on Outcome in Patients with Head and Neck Cancer Treated with Definitive Radio(Chemo)Therapy

Have actual waiting times been reduced by introducing the DILO reform for cancer patients in Poland?

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