Chun-Ta Liao1, Hsin-Ni Chen2, Yu-Wen Wen3, Shu Ru Lee3, Shu-Hang Ng4, Tsang-Wu Liu5, Sen-Tien Tsai6, Ming-Hsui Tsai7, Jin-Ching Lin8, Pei-Jen Lou9, Cheng Ping Wang9, Pen-Yuan Chu10, Yi-Shing Leu11, Kuo-Yang Tsai12, Shyuang-Der Terng13, Tsung-Ming Chen14, Cheng-Hsu Wang15, Chih-Yen Chien16, Wen-Cheng Chen17, Li-Yu Lee18, Chien-Yu Lin19, Hung-Ming Wang20, Chih-Hung Lin21, Tuan-Jen Fang1, Shiang-Fu Huang1, Chung-Jan Kang1, Kai-Ping Chang1, Lan Yan Yang22, Tzu-Chen Yen23. 1. Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan. 2. Nursing Department, Chang Gung Memorial Hospital and School of Nursing, Chang Gung University, Taoyuan, Taiwan. 3. Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan, Taiwan. 4. Department of Diagnostic Radiology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan. 5. National Institute of Cancer Research, National Health Research Institutes, Taiwan. 6. Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Taiwan. 7. Department of Otorhinolaryngology, Head and Neck Surgery, China Medical University Hospital, Taiwan. 8. Department of Radiation Oncology, Taichung Veterans General Hospital, Taichung, Taiwan. 9. Department of Otolaryngology, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan. 10. Department of Otolaryngology, Taipei Veterans General Hospital, Taipei, Taiwan. 11. Department of Otolaryngology, Mackay Memorial Hospital, Taipei, Taiwan. 12. Department of Oral and Maxillofacial Surgery, Head and Neck Surgery, Changhua Christian Hospital, Changhua, Taiwan. 13. Department of Head and Neck Surgery, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan. 14. Department of Otolaryngology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan. 15. Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan. 16. Department of Otolaryngology, Chang Gung Memorial Hospital - Kaohsiung Medical Center, Chang Gung University College of Medicine, Taiwan. 17. Department of Radiation Oncology, Chang Gung Memorial Hospital, Chiayi, Taiwan. 18. Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan. 19. Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan. 20. Department of Medical Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan. 21. Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan. 22. Biostatistics and Informatics Unit, Clinical Trial Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan. Electronic address: lyyang0111@gmail.com. 23. Department of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan. Electronic address: yentc1110@gmail.com.
Abstract
BACKGROUND: To investigate the association between the diagnosis-to-treatment interval (DTI) and overall survival (OS) in patients with oral cavity squamous cell carcinoma (OSCC). METHODS: A total of 18,677 patients with first primary OSCC identified in the Taiwanese Cancer Registry Database between 2004 and 2010 were examined. The effect of DTI on 5-year OS rates was investigated with multivariate Cox regression analysis. After the identification of the optimal cutoff for DTI based on the 5-year OS rates, DTI was classified in the following 20-day groups: ≤20 days (57% of the study patients), 21-45 days (34%), 46-90 days (6%) and ≥91 days (3%). In additional exploratory analyses, DTI was reclassified in the following 30-day interval groups: ≤30 days (81% of the study patients), 31-60 days (14%), 61-90 days (2%) and ≥91 days (3%). RESULTS: Multivariate analyses identified DTI (≤20 days versus other subgroups), sex (female versus male), age (<65 versus ≥65 years), clinical stage (p-stage I versus p-stage II, III, IV) and treatment modality (initial surgery versus initial non-surgery) as independent prognostic factors for 5-year OS. Compared with a DTI ≤20 days, the DTI categories ≥91 days (hazard ratio [HR]: 1.28, P < 0.001), 46-90 days (HR: 1.25, P < 0.001) and 21-45 days (HR: 1.07, P = 0.007) were independently associated with a higher risk of 5-year mortality. Similar results were obtained for DTI ≤30 days groups. CONCLUSIONS: DTI is independently associated with 5-year OS in OSCC patients. A DTI longer than 30 days or even 20 days may potentially decrease survival.
BACKGROUND: To investigate the association between the diagnosis-to-treatment interval (DTI) and overall survival (OS) in patients with oral cavity squamous cell carcinoma (OSCC). METHODS: A total of 18,677 patients with first primary OSCC identified in the Taiwanese Cancer Registry Database between 2004 and 2010 were examined. The effect of DTI on 5-year OS rates was investigated with multivariate Cox regression analysis. After the identification of the optimal cutoff for DTI based on the 5-year OS rates, DTI was classified in the following 20-day groups: ≤20 days (57% of the study patients), 21-45 days (34%), 46-90 days (6%) and ≥91 days (3%). In additional exploratory analyses, DTI was reclassified in the following 30-day interval groups: ≤30 days (81% of the study patients), 31-60 days (14%), 61-90 days (2%) and ≥91 days (3%). RESULTS: Multivariate analyses identified DTI (≤20 days versus other subgroups), sex (female versus male), age (<65 versus ≥65 years), clinical stage (p-stage I versus p-stage II, III, IV) and treatment modality (initial surgery versus initial non-surgery) as independent prognostic factors for 5-year OS. Compared with a DTI ≤20 days, the DTI categories ≥91 days (hazard ratio [HR]: 1.28, P < 0.001), 46-90 days (HR: 1.25, P < 0.001) and 21-45 days (HR: 1.07, P = 0.007) were independently associated with a higher risk of 5-year mortality. Similar results were obtained for DTI ≤30 days groups. CONCLUSIONS: DTI is independently associated with 5-year OS in OSCC patients. A DTI longer than 30 days or even 20 days may potentially decrease survival.
Authors: S Kassirian; A Dzioba; S Hamel; K Patel; A Sahovaler; D A Palma; N Read; V Venkatesan; A C Nichols; J Yoo; K Fung; A Mendez; S D MacNeil Journal: Curr Oncol Date: 2020-10-01 Impact factor: 3.677
Authors: Allen S Ho; Sungjin Kim; Mourad Tighiouart; Alain Mita; Kevin S Scher; Joel B Epstein; Anna Laury; Ravi Prasad; Nabilah Ali; Chrysanta Patio; Jon Mallen-St Clair; Zachary S Zumsteg Journal: Cancer Date: 2018-05-09 Impact factor: 6.860
Authors: José Luis Lopez-Cedrún; Ana Otero-Rico; Inés Vázquez-Mahía; Juan Seoane; Lucía García-Caballero; Juan Manuel Seoane-Romero; Pablo Varela-Centelles Journal: PLoS One Date: 2019-10-25 Impact factor: 3.240
Authors: Timothy P Hanna; Will D King; Stephane Thibodeau; Matthew Jalink; Gregory A Paulin; Elizabeth Harvey-Jones; Dylan E O'Sullivan; Christopher M Booth; Richard Sullivan; Ajay Aggarwal Journal: BMJ Date: 2020-11-04