Association between the diagnosis-to-treatment interval and overall survival in Taiwanese patients with oral cavity squamous cell carcinoma. (February 2017)

• Record Type: Journal Article
• Authors: Liao, Chun-Ta; Chen, Hsin-Ni; Wen, Yu-Wen; Lee, Shu Ru; Ng, Shu-Hang; Liu, Tsang-Wu; Tsai, Sen-Tien; Tsai, Ming-Hsui; Lin, Jin-Ching; Lou, Pei-Jen; Wang, Cheng Ping; Chu, Pen-Yuan; Leu, Yi-Shing; Tsai, Kuo-Yang; Terng, Shyuang-Der; Chen, Tsung-Ming; Wang, Cheng-Hsu; Chien, Chih-Yen; Chen, Wen-Cheng; Lee, Li-Yu; Lin, Chien-Yu; Wang, Hung-Ming; Lin, Chih-Hung; Fang, Tuan-Jen; Huang, Shiang-Fu; Kang, Chung-Jan; Chang, Kai-Ping; Yang, Lan Yan; Yen, Tzu-Chen
• Is Part Of: European journal of cancer. Volume 72(2017)
• Page Start: 226
• Page End: 234
• Publication Date: 2017-02
• Subjects: Treatment delay -- Oral cavity squamous cell carcinoma -- Diagnosis to treatment interval -- Outcome -- Cancer database; Cancer -- Periodicals; Neoplasms -- Periodicals; Cancer -- Périodiques; Cancer; Tumors; Electronic journals; Periodicals; Electronic journals; 616.994
• DOI: 10.1016/j.ejca.2016.11.010
• Languages: English
• ISSNs: 0959-8049

Abstract

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. Highlights: It is still unclear whether delayed treatment can negatively affect survival in oral cavity squamous cell carcinoma. A prolonged diagnosis-to-treatment interval (DTI) was an adverse prognostic factor. A DTI longer than 20–30 days may potentially decrease overall survival.