Madelyn N Stevens1, Ankita Patro2, Bushra Rahman3, Yue Gao4, Dandan Liu4, Anthony Cmelak5, Jamie Wiggleton2, Young Kim2, Alexander Langerman2, Kyle Mannion2, Robert Sinard2, James Netterville2, Sarah L Rohde2, Michael C Topf2. 1. Department of Otolaryngology Head and Neck Surgery, Vanderbilt University Medical Center, 7(th) floor 1215 21(st) Ave S, Nashville, TN 37232, USA. Electronic address: Madelyn.stevens@vumc.org. 2. Department of Otolaryngology Head and Neck Surgery, Vanderbilt University Medical Center, 7(th) floor 1215 21(st) Ave S, Nashville, TN 37232, USA. 3. Vanderbilt University School of Medicine, 1161 21(st) Ave S, Nashville, TN 37232, USA. 4. Department of Biostatistics, Vanderbilt University, 2525 West End Ave Ste 1100, Nashville, TN 37203, USA. 5. Department of Radiation Oncology, Vanderbilt University Medical Center, 2220 Pierce Ave, Nashville, TN 37232, USA.
The authors appreciate the opportunity to reply to the recent commentary [1] that notes that the increase in patients presenting with head and neck malignancy found in our study population [2] was not reflected in a similar European study [3]. Our key finding of mucosal squamous cell carcinoma patient's presenting with more advanced disease during the pandemic (specifically, more advanced N staging) has direct impact for treatment choice and long-term outcomes. A similar study by Solis et al. reported more advanced T classification [4]. Taken together, these reports have implications for overall and disease-specific survival of head and neck cancer patients treated during the COVID-19 pandemic and highlight the need to better understand the changing referral and treatment patterns as the pandemic continues.Regional differences in patient demographics and access to care are not unexpected, particularly with varying responses to the pandemic. The patient population described in our initial study includes a catchment area of the mid-southern United States. We found that despite more advanced disease, there was faster initiation of treatment during the pandemic than during a similar pre-pandemic timeframe. When comparing all newly diagnosed head and neck cancers seen in a tertiary care clinic, there was significantly decreased time from referral to first clinic appointment (11 days v 9 days, p < 0.001) and time from referral to surgery (38 days v 27 days, p < 0.001) [5]. We hypothesize that this was due to increased availability of clinic appointments and operating rooms. We agree that there are clear differences in accessibility and treatment during the pandemic, and this data suggests head and neck oncologic care can still be delivered quickly and efficiently, even during the ongoing COVID-19 pandemic. It will be important to continue to follow these patients to determine the true effect that advanced clinical presentation during the COVID-19 pandemic has on oncologic outcomes.
Funding
This work was supported in part by the Vanderbilt CTSA grant from / [UL1TR002243].
Authors: Roberto N Solis; Mehrnaz Mehrzad; Samya Faiq; Roberto P Frusciante; Harveen K Sekhon; Marianne Abouyared; Arnaud F Bewley; D Gregory Farwell; Andrew C Birkeland Journal: OTO Open Date: 2021-12-23
Authors: Rosanne C Schoonbeek; Dominique V C de Jel; Boukje A C van Dijk; Stefan M Willems; Elisabeth Bloemena; Frank J P Hoebers; Esther van Meerten; Berit M Verbist; Ludi E Smeele; György B Halmos; Matthias A W Merkx; Sabine Siesling; Remco De Bree; Robert P Takes Journal: Radiother Oncol Date: 2021-12-13 Impact factor: 6.280
Authors: Madelyn N Stevens; Ankita Patro; Bushra Rahman; Yue Gao; Dandan Liu; Anthony Cmelak; Jamie Wiggleton; Young J Kim; Alexander Langerman; Kyle Mannion; Robert J Sinard; James L Netterville; Sarah L Rohde; Michael C Topf Journal: Am J Otolaryngol Date: 2021-10-08 Impact factor: 1.808