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Association between the diagnosis-to-treatment interval and overall survival in Taiwanese patients with oral cavity squamous cell carcinoma

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机构: [1]Chang Gung Mem Hosp, Dept Otorhinolaryngol Head & Neck Surg, Taoyuan, Taiwan; [2]Chang Gung Univ, Taoyuan, Taiwan; [3]Chang Gung Mem Hosp, Dept Nursing, Taoyuan, Taiwan; [4]Chang Gung Univ, Sch Nursing, Taoyuan, Taiwan; [5]Chang Gung Univ, Clin Informat & Med Stat Res Ctr, Taoyuan, Taiwan; [6]Chang Gung Mem Hosp, Dept Diagnost Radiol, Taoyuan, Taiwan; [7]Chang Gung Univ, Taoyuan, Taiwan; [8]Natl Hlth Res Inst, Natl Inst Canc Res, Taipei, Taiwan; [9]Natl Cheng Kung Univ, Natl Cheng Kung Univ Hosp, Dept Otolaryngol, Coll Med, Tainan, Taiwan; [10]China Med Univ Hosp, Dept Otorhinolaryngol Head & Neck Surg, Taichung, Taiwan; [11]Taichung Vet Gen Hosp, Dept Radiat Oncol, Taichung, Taiwan; [12]Natl Taiwan Univ Hosp, Dept Otolaryngol, Taipei, Taiwan; [13]Coll Med, Taipei, Taiwan; [14]Taipei Vet Gen Hosp, Dept Otolaryngol, Taipei, Taiwan; [15]Mackay Mem Hosp, Dept Otolaryngol, Taipei, Taiwan; [16]Changhua Christian Hosp, Dept Oral & Maxillofacial Surg, Head & Neck Surg, Changhua, Taiwan; [17]Koo Fdn, Dept Head & Neck Surg, Sun Yat Sen Canc Ctr, Taipei, Taiwan; [18]Taipei Med Univ, Shuang Ho Hosp, Dept Otolaryngol, New Taipei, Taiwan; [19]Chang Gung Mem Hosp, Div Hematol Oncol, Dept Internal Med, Keelung, Taiwan; [20]Chang Gung Univ, Chang Gung Mem Hosp, Dept Otolaryngol, Coll Med,Kaohsiung Med Ctr, Taoyuan, Taiwan; [21]Chang Gung Mem Hosp, Dept Radiat Oncol, Chiayi, Taiwan; [22]Chang Gung Mem Hosp, Dept Pathol, Taoyuan, Taiwan; [23]Chang Gung Mem Hosp, Dept Radiat Oncol, Taoyuan, Taiwan; [24]Chang Gung Mem Hosp, Dept Med Oncol, Taoyuan, Taiwan; [25]Chang Gung Mem Hosp, Dept Plast & Reconstruct Surg, Taoyuan, Taiwan; [26]Chang Gung Mem Hosp, Clin Trial Ctr, Biostat & Informat Unit, Taoyuan, Taiwan; [27]Chang Gung Mem Hosp, Dept Nucl Med, Taoyuan, Taiwan; [28]Chang Gung Mem Hosp, Mol Imaging Ctr, Taoyuan, Taiwan; [29]Chang Gung Mem Hosp Linkou, Dept Nucl Med, 5 Fu Hsing ST, Taoyuan, Taiwan; [30]Chang Gung Mem Hosp Linkou, Clin Trial Ctr, Biostat & Informat Unit, 5 Fu Hsing ST, Taoyuan, Taiwan
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关键词: Treatment delay Oral cavity squamous cell carcinoma Diagnosis to treatment interval Outcome Cancer database

摘要:
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. (C) 2016 Elsevier Ltd. All rights reserved.

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出版当年[2017]版:
大类 | 2 区 医学
小类 | 2 区 肿瘤学
最新[2023]版:
大类 | 1 区 医学
小类 | 2 区 肿瘤学
第一作者:
第一作者机构: [1]Chang Gung Mem Hosp, Dept Otorhinolaryngol Head & Neck Surg, Taoyuan, Taiwan; [2]Chang Gung Univ, Taoyuan, Taiwan;
通讯作者:
通讯机构: [7]Chang Gung Univ, Taoyuan, Taiwan; [26]Chang Gung Mem Hosp, Clin Trial Ctr, Biostat & Informat Unit, Taoyuan, Taiwan; [27]Chang Gung Mem Hosp, Dept Nucl Med, Taoyuan, Taiwan; [28]Chang Gung Mem Hosp, Mol Imaging Ctr, Taoyuan, Taiwan; [29]Chang Gung Mem Hosp Linkou, Dept Nucl Med, 5 Fu Hsing ST, Taoyuan, Taiwan; [30]Chang Gung Mem Hosp Linkou, Clin Trial Ctr, Biostat & Informat Unit, 5 Fu Hsing ST, Taoyuan, Taiwan
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