Influence of time interval from diagnosis to treatment on survival for oral cavity cancer: A nationwide cohort study

Tsai, Wen‐Chen; Kung, Pei‐Tseng; Wang, Yueh-Hsin; Huang, Kuang‐Hua; Liu, Shih–An

doi:10.1371/journal.pone.0175148

Cited by 43 publications

(54 citation statements)

References 27 publications

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“…Six studies (46%) 10,33,36–39 included all head and neck subsites, while 7 studies (54%) were subsite specific (5 oral cavity, 1 oropharynx, and 1 larynx). 19,22,30–32,34,35 Four of the studies (31%) 22,31,33,36 did not define the rationale or methods for their definition of prolonged DTI, 4 (31%) 19,35,37,38 used calendar-based categorical definitions (eg, <30 days, 31–60 days), 3 (23%) 30,34,39 used cohort-based quartiles or medians, and 2 (15%) 10,32 used recursive partition analysis to determine an optimal DTI threshold. One study, which exclusively examined cancer of the oral cavity, suggested that DTI of less than 20 days was optimal.…”

Section: Resultsmentioning

confidence: 99%

“…10 An association between delays in DTI and poorer oncologic outcomes was observed in 9 studies (69%). 10,22,31–37 The delayed DTI threshold varied from more than 20 days to 120 days or more. The 4 studies that did not find an association between DTI and survival analyzed thresholds of 50 days or more (vs 24days or less), 45 days or more (vs 30 days or less), and more than 30 days (vs 30 days or less; analyzed in 2 studies).…”

Section: Resultsmentioning

confidence: 99%

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Association of Treatment Delays With Survival for Patients With Head and Neck Cancer

Graboyes

Kompelli

Neskey

et al. 2019

JAMA Otolaryngol Head Neck Surg

222

313

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IMPORTANCE Delays in the delivery of care for head and neck cancer (HNC) are a key driver of poor oncologic outcomes and thus represent an important therapeutic target. OBJECTIVE To synthesize information about the association between delays in the delivery of care for HNC and oncologic outcomes. EVIDENCE REVIEW A systematic review of the English-language literature in PubMed/MEDLINE and Scopus published between January 1, 2007, and February 28, 2018, was performed to identify articles addressing the association between treatment delays and oncologic outcomes for patients with HNC. Articles that were included (1) addressed cancer of the oral cavity, oropharynx, hypopharynx, or larynx; (2) discussed patients treated in 2004 or later; (3) analyzed time of diagnosis to treatment initiation (DTI), time from surgery to the initiation of postoperative radiotherapy, and/or treatment package time (TPT; the time from surgery through the completion of postoperative radiotherapy); (4) included a clear definition of treatment delay; and (5) analyzed the association between the treatment time interval and an oncologic outcome measure. Quality assessment was performed using the Institute of Health Economics Quality Appraisal Checklist for Case Series Studies. FINDINGS A total of 18 studies met inclusion criteria and formed the basis of the systematic review. Nine studies used the National Cancer Database and 6 studies were single-institution retrospective reviews. Of the 13 studies assessing DTI, 9 found an association between longer DTI and poorer overall survival; proposed DTI delay thresholds ranged from more than 20 days to 120 days or more. Four of the 5 studies assessing time from surgery to the initiation of postoperative radiotherapy (and all 4 studies assessing guideline-adherent time to postoperative radiotherapy) found an association between a timely progression from surgery to the initiation of postoperative radiotherapy and improved overall or recurrence-free survival. Of the 5 studies examining TPT, 4 found that prolonged TPT correlated with poorer overall survival; proposed thresholds for prolonged TPT ranged from 77 days or more to more than 100 days. CONCLUSIONS AND RELEVANCE Timely care regarding initiation of treatment, postoperative radiotherapy, and TPT is associated with survival for patients with HNC, although significant heterogeneity exists for defining delayed DTI and TPT. Further research is required to standardize optimal time goals, identify barriers to timely care for each interval, and design interventions to minimize delays.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Association of Treatment Delays With Survival for Patients With Head and Neck Cancer

Graboyes

Kompelli

Neskey

et al. 2019

JAMA Otolaryngol Head Neck Surg

222

313

View full text Add to dashboard Cite

show abstract

“…Time to treatment initiation (TTI) is a proposed national health care metric in the era of quality‐based reimbursement . Previous studies among patients with HNSCC have associated increasing TTI with worsening mortality . This relationship may be multifaceted, with sociodemographic issues, management of comorbid conditions, and complexity of treatment modalities all contributing to increased TTI and decreased overall survival (OS).…”

Section: Introductionmentioning

confidence: 99%

“…4 Previous studies among patients with HNSCC have associated increasing TTI with worsening mortality. 5,6 This relationship may be multifaceted, with sociodemographic issues, management of comorbid conditions, and complexity of treatment modalities all contributing to increased TTI and decreased overall survival (OS). It is possible that tumor progression contributes minimally to worsening mortality for those patients experiencing treatment delay, and that expediting care through an already stressed health care system may be a misplaced national emphasis.…”

Section: Introductionmentioning

confidence: 99%

Increased pathologic upstaging with rising time to treatment initiation for head and neck cancer: A mechanism for increased mortality

Xiao

Ward

Yang

et al. 2018

Cancer

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“…Therefore, treatment delay due to referral time or financial barriers should not occur often in Taiwan. However, some studies still found that cancer patients did not receive prompt treatment upon diagnosis [ 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Influence of the time interval from diagnosis to treatment on survival for early-stage liver cancer

et al. 2018

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ObjectivesLiver cancer is the fifth most common cancer in men and the ninth most common cancer in women, and the WHO expects that there will be 1,341,344 cases in 2034 worldwide. Liver cancer also has the second-highest cancer death rate, accounting for 7% of all cancers. The study is going to explore the relationship between time interval from diagnosis to treatment and survival status of early-stage liver cancer patients.Materials and methodsThis is a retrospective cohort study using the national database from Taiwan. The datasets include the Taiwan Cancer Registry Database (TCR), the National Health Insurance Research Database (NHIRD), and the National Registry of Deaths. The target population for the study was patients newly diagnosed with stage I and stage II liver cancer between the years 2004 and 2010. Total of 26,038 cases were included in the study. Except descriptive analysis, the relationship between patient characteristics and the time interval from diagnosis to treatment was examined by chi-square tests. In addition, modified Cox proportional hazard models were used to analyze the hazard ratio of patient death with various treatment delay durations.ResultsThere were 20,430 patients (78.46%) who received treatment less than 30 days after diagnosis, while 2,674 patients (10.27%) received treatment between 31 and 60 days after diagnosis, and 2,068 patients (7.94%) received treatment between 61 and 180 days after diagnosis, and 866 patients (3.33%) who received treatment 181 days after diagnosis. Those treated more than 181 days and 61–180 days after diagnosis had a 1.68-fold increased risk of death (95% confidence interval: 1.50–1.88) and a 1.39-fold increased risk of death (95% confidence interval: 1.31–1.17), respectively. Being male, being elderly, having a higher CCI level, and being treated in a hospital with a low service volume were factors associated with a poorer prognosis.ConclusionOverall, this study utilized a national cohort to conclude that for early-stage liver cancer patients, a longer the time interval from diagnosis to treatment results in a lower survival rate.

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Influence of time interval from diagnosis to treatment on survival for oral cavity cancer: A nationwide cohort study

Cited by 43 publications

References 27 publications

Association of Treatment Delays With Survival for Patients With Head and Neck Cancer

Association of Treatment Delays With Survival for Patients With Head and Neck Cancer

Increased pathologic upstaging with rising time to treatment initiation for head and neck cancer: A mechanism for increased mortality

Influence of the time interval from diagnosis to treatment on survival for early-stage liver cancer

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