Waiting times during the management of head and neck tumours

Jones, Toby Craig; Hargrove, O.; Lancaster, Jeffrey; Fenton, John E.; Shenoy, Aditya; Roland, N J

doi:10.1258/0022215021910744

Cited by 24 publications

(15 citation statements)

References 10 publications

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“…Several studies, primarily from Europe, have documented the time required for treatment initiation. These times range from 2.7 months from symptom recognition to diagnosis, to 4.9 months from symptom recognition to presentation for definitive care 22,23. A separate study documented that delays in treatment initiation correlate with decreased survival 24.…”

Section: Discussionmentioning

confidence: 99%

Barriers to early detection and treatment of head and neck squamous cell carcinoma in African American men

et al. 2009

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African Amercians afflicted with HNSCCA have a strikingly worse survival than whites. One apparent cause is an advanced stage of presentation in African Americans. This study was designed to identify barriers to early treatment among African American men.Methods-Twenty four African American male HNSCCA survivors completed structured interviews. Interviewers elicited the participants' experiences from symptom recognition to receiving definitive care.Results-Most participants presented with advanced stage HNSCCA. Overall, 10% experienced barriers to obtaining early medical care, though 30% were hesitant to seek care due to perceived barriers. Definitive treatment began for 81% within three months of initially seeking care.Conclusion-Once participants sought care, most received definitive treatment within a reasonable timeframe. To explain the advanced stage at presentation, either tumor growth rate was extremely rapid, or, participants sought care when the tumor was quite advanced. The themes suggested by this elicitation study require further validation.

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Section: Discussionmentioning

confidence: 99%

Barriers to early detection and treatment of head and neck squamous cell carcinoma in African American men

et al. 2009

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“…Scully et al (1986) found a mean delay of 3.5 months from first symptom awareness to referral from primary care in oral cancer patients, although Onizawa et al (2003), also in oral cancer patients, found a mean of 2.7 months to diagnosis. Jones et al (2002) in head and neck cancer patients found a mean 4.9 months to presentation at secondary care. Amir et al (1999) studied within-patient-delay specifically and found a mean 7.4 weeks for oral cancer patients and 12.3 weeks for other head and neck cancers.…”

mentioning

confidence: 99%

Delay in referral of oropharyngeal squamous cell carcinoma to secondary care correlates with a more advanced stage at presentation, and is associated with poorer survival

Pitchers

Martin

2006

Br J Cancer

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Squamous carcinoma of the oropharynx presents with symptoms common to many benign diseases, and this can cause delay in referral to secondary care. We investigate delay in referral, defining this as the time from symptom-onset to date of general practitioners referral letter to secondary care, and the effect of that delay, using a retrospective case notes based study of patients presenting at our institution with oropharyngeal squamous carcinoma between 1995 and 2005. Using correlation analysis and ordinal regression, we examined the relationship between increased referral delay from primary care, clinical stage at presentation, and survival. Increasing time from symptom onset to referral to secondary care was positively correlated with more advanced disease stage at presentation (r s ¼ þ 0.346, P ¼ 0.004). This was confirmed with ordinal regression modelling (delay estimate ¼ 0.045, P ¼ 0.042). Patients with delay of less than 6 weeks had significantly improved survival compared to those with a delay of greater than 6 weeks (P ¼ 0.032). For every 1 week of delay in referral, we estimate that the stage of presentation will progress by 0.045 of 'a stage'.

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“…In countries with limited resources and, to an extent, even in western countries, there is another concern related to long waiting lists and delays of 1-2 months before surgery [12,13] . Chemotherapy could theoretically be useful to prevent progression during the waiting period.…”

Section: Preoperative Chemotherapy In Resectable Oral Cancersmentioning

confidence: 99%

Preoperative Chemotherapy and Metronomic Scheduling of Chemotherapy in Locally Advanced Oral Cancers

et al. 2016

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Locally advanced oral cavity cancers are treated with a multi-modality approach. Surgery is the most efficient local modality in comparison to chemoradiation in oral cancers. Preoperative chemotherapy has failed its expectations to improve disease-free survival or overall survival in resectable oral cancers. Its use as an organ preservation tool is being studied. Induction chemotherapy followed by assessment for surgery is an appropriate option for borderline resectable or technically unresectable oral cancer. Metronomic chemotherapy is being studied as a bridge to surgery and as adjuvant chemotherapy in locally advanced oral cancers. The role of induction chemotherapy in unresectable oral cancers is unproven. Metronomic chemotherapy has shown improved progression-free survival and overall survival in oral cancers in comparison to intravenous cisplatin. A phase 3 study for confirmation of this finding has begun.

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Waiting times during the management of head and neck tumours

Cited by 24 publications

References 10 publications

Barriers to early detection and treatment of head and neck squamous cell carcinoma in African American men

Barriers to early detection and treatment of head and neck squamous cell carcinoma in African American men

Delay in referral of oropharyngeal squamous cell carcinoma to secondary care correlates with a more advanced stage at presentation, and is associated with poorer survival

Preoperative Chemotherapy and Metronomic Scheduling of Chemotherapy in Locally Advanced Oral Cancers

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