Association between treatment delays and oncologic outcome in patients treated with surgery and radiotherapy for head and neck cancer

Vasu Tumati; Lawrence Hoang; Baran D Sumer; John M Truelson; Larry L Myers; Saad Khan; Randall S Hughes; Lucien A Nedzi; David J Sher

doi:10.1002/hed.25457

Association between treatment delays and oncologic outcome in patients treated with surgery and radiotherapy for head and neck cancer

Vasu Tumati, Lawrence Hoang, Baran D Sumer, John M Truelson, Larry L Myers, Saad Khan, Randall S Hughes, Lucien A Nedzi, David J Sher

Research output: Contribution to journal › Article › peer-review

16 Scopus citations

Abstract

Background: This study sought to determine the oncologic impact of delays to surgery, radiotherapy, and completion of therapy in patients with head and neck squamous cell carcinoma. Methods: The impact of biopsy to surgery (BTS) time, surgery to start of radiation time (STSR), and radiation treatment time (RTT) on locoregional recurrence (LRR), distant metastases (DMs), and cancer-specific mortality (CSM) was examined. The cumulative incidences (CI) of LRR, DMs, and CSM were examined using Fine–Gray testing. Results: A total of 277 patients treated with surgery and adjuvant radiotherapy were analyzed. On multivariable testing, BTS >50 days was associated with DM (P =.03), whereas RTT and STSR were not. RTT >43 days was associated with LRR (P =.02) in patients with non-p16-positive-oropharynx cancer. Conclusions: An increase in DM appears to be the mechanism by which prolonged time to treatment initiation leads to worse overall survival. Prolonged RTT has the greatest impact on patients with non-p16 positive oropharynx cancers.

Original language	English (US)
Pages (from-to)	315-321
Number of pages	7
Journal	Head and Neck
Volume	41
Issue number	2
DOIs	https://doi.org/10.1002/hed.25457
State	Published - Feb 2019

Keywords

adjuvant radiation therapy
head and neck cancer
time to treatment initiation
treatment delays

ASJC Scopus subject areas

Otorhinolaryngology

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10.1002/hed.25457

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title = "Association between treatment delays and oncologic outcome in patients treated with surgery and radiotherapy for head and neck cancer",

abstract = "Background: This study sought to determine the oncologic impact of delays to surgery, radiotherapy, and completion of therapy in patients with head and neck squamous cell carcinoma. Methods: The impact of biopsy to surgery (BTS) time, surgery to start of radiation time (STSR), and radiation treatment time (RTT) on locoregional recurrence (LRR), distant metastases (DMs), and cancer-specific mortality (CSM) was examined. The cumulative incidences (CI) of LRR, DMs, and CSM were examined using Fine–Gray testing. Results: A total of 277 patients treated with surgery and adjuvant radiotherapy were analyzed. On multivariable testing, BTS >50 days was associated with DM (P =.03), whereas RTT and STSR were not. RTT >43 days was associated with LRR (P =.02) in patients with non-p16-positive-oropharynx cancer. Conclusions: An increase in DM appears to be the mechanism by which prolonged time to treatment initiation leads to worse overall survival. Prolonged RTT has the greatest impact on patients with non-p16 positive oropharynx cancers.",

keywords = "adjuvant radiation therapy, head and neck cancer, time to treatment initiation, treatment delays",

author = "Vasu Tumati and Lawrence Hoang and Sumer, {Baran D} and Truelson, {John M} and Myers, {Larry L} and Saad Khan and Hughes, {Randall S} and Nedzi, {Lucien A} and Sher, {David J}",

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year = "2019",

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doi = "10.1002/hed.25457",

language = "English (US)",

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T1 - Association between treatment delays and oncologic outcome in patients treated with surgery and radiotherapy for head and neck cancer

AU - Tumati, Vasu

AU - Hoang, Lawrence

AU - Sumer, Baran D

AU - Truelson, John M

AU - Myers, Larry L

AU - Khan, Saad

AU - Hughes, Randall S

AU - Nedzi, Lucien A

AU - Sher, David J

PY - 2019/2

Y1 - 2019/2

N2 - Background: This study sought to determine the oncologic impact of delays to surgery, radiotherapy, and completion of therapy in patients with head and neck squamous cell carcinoma. Methods: The impact of biopsy to surgery (BTS) time, surgery to start of radiation time (STSR), and radiation treatment time (RTT) on locoregional recurrence (LRR), distant metastases (DMs), and cancer-specific mortality (CSM) was examined. The cumulative incidences (CI) of LRR, DMs, and CSM were examined using Fine–Gray testing. Results: A total of 277 patients treated with surgery and adjuvant radiotherapy were analyzed. On multivariable testing, BTS >50 days was associated with DM (P =.03), whereas RTT and STSR were not. RTT >43 days was associated with LRR (P =.02) in patients with non-p16-positive-oropharynx cancer. Conclusions: An increase in DM appears to be the mechanism by which prolonged time to treatment initiation leads to worse overall survival. Prolonged RTT has the greatest impact on patients with non-p16 positive oropharynx cancers.

AB - Background: This study sought to determine the oncologic impact of delays to surgery, radiotherapy, and completion of therapy in patients with head and neck squamous cell carcinoma. Methods: The impact of biopsy to surgery (BTS) time, surgery to start of radiation time (STSR), and radiation treatment time (RTT) on locoregional recurrence (LRR), distant metastases (DMs), and cancer-specific mortality (CSM) was examined. The cumulative incidences (CI) of LRR, DMs, and CSM were examined using Fine–Gray testing. Results: A total of 277 patients treated with surgery and adjuvant radiotherapy were analyzed. On multivariable testing, BTS >50 days was associated with DM (P =.03), whereas RTT and STSR were not. RTT >43 days was associated with LRR (P =.02) in patients with non-p16-positive-oropharynx cancer. Conclusions: An increase in DM appears to be the mechanism by which prolonged time to treatment initiation leads to worse overall survival. Prolonged RTT has the greatest impact on patients with non-p16 positive oropharynx cancers.

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KW - head and neck cancer

KW - time to treatment initiation

KW - treatment delays

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Association between treatment delays and oncologic outcome in patients treated with surgery and radiotherapy for head and neck cancer

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