Alexander N Goel1, Mariana Frangos1, Govind Raghavan1, Sophia Sangar1, Stephanie Lazaro1, Marilene B Wang1,2,3, Jennifer L Long1,4, Maie A St John1,2,3. 1. Department of Head and Neck Surgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California. 2. Jonsson Comprehensive Cancer Center, UCLA Medical Center, Los Angeles, California. 3. UCLA Head and Neck Cancer Program, UCLA Medical Center, Los Angeles, California. 4. Research Service, Department of Veterans Affairs, Los Angeles, California.
Abstract
BACKGROUND: The impact of treatment delays on survival in oropharyngeal cancer and whether the effect varies by human papillomavirus (HPV) status have yet to be defined. METHODS: Retrospective analysis of the survival impact of time from diagnosis to surgery (DTS), surgery to radiation (SRT), and duration of radiation (RTD) for patients in the National Cancer Database with resected oropharyngeal cancer who underwent adjuvant radiation from 2010 to 2014. RESULTS: We identified optimal thresholds of 30, 40, and 51 days for DTS, SRT, and RTD, respectively, with treatment times exceeding these thresholds associated with significantly worse overall survival. Prolonged SRT and RTD were associated with mortality regardless of HPV status, although rising DTS was only predictive among patients with HPV-negative tumors. CONCLUSIONS: Treatment delays significantly impact survival in oropharyngeal cancer. The consequences of prolonged DTS may be stronger in HPV-negative than HPV-positive disease. These data serve as a foundation for future research and clinical management.
BACKGROUND: The impact of treatment delays on survival in oropharyngeal cancer and whether the effect varies by human papillomavirus (HPV) status have yet to be defined. METHODS: Retrospective analysis of the survival impact of time from diagnosis to surgery (DTS), surgery to radiation (SRT), and duration of radiation (RTD) for patients in the National Cancer Database with resected oropharyngeal cancer who underwent adjuvant radiation from 2010 to 2014. RESULTS: We identified optimal thresholds of 30, 40, and 51 days for DTS, SRT, and RTD, respectively, with treatment times exceeding these thresholds associated with significantly worse overall survival. Prolonged SRT and RTD were associated with mortality regardless of HPV status, although rising DTS was only predictive among patients with HPV-negative tumors. CONCLUSIONS: Treatment delays significantly impact survival in oropharyngeal cancer. The consequences of prolonged DTS may be stronger in HPV-negative than HPV-positive disease. These data serve as a foundation for future research and clinical management.
Authors: Michael C Topf; Jared A Shenson; F Christopher Holsinger; Samuel H Wald; Lisa J Cianfichi; Eben L Rosenthal; John B Sunwoo Journal: Head Neck Date: 2020-05-06 Impact factor: 3.147
Authors: John R de Almeida; Christopher W Noel; David Forner; Han Zhang; Anthony C Nichols; Marc A Cohen; Richard J Wong; Caitlin McMullen; Evan M Graboyes; Vasu Divi; Andrew G Shuman; Andrew J Rosko; Carol M Lewis; Ehab Y Hanna; Jeffrey Myers; Vinidh Paleri; Brett Miles; Eric Genden; Antoine Eskander; Danny J Enepekides; Kevin M Higgins; Dale Brown; Douglas B Chepeha; Ian J Witterick; Patrick J Gullane; Jonathan C Irish; Eric Monteiro; David P Goldstein; Ralph Gilbert Journal: Cancer Date: 2020-08-11 Impact factor: 6.860