Survival impact of treatment delays in surgically managed oropharyngeal cancer and the role of human papillomavirus status

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 dura...

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Bibliographic Details
Published in:Head & neck 2019-06, Vol.41 (6), p.1756-1769
Main Authors: Goel, Alexander N., Frangos, Mariana, Raghavan, Govind, Sangar, Sophia, Lazaro, Stephanie, Wang, Marilene B., Long, Jennifer L., St. John, Maie A.
Format: Article
Language:English
Subjects:
Cancer
Head and neck
Human papillomavirus
human papillomavirus, treatment delay
National Cancer Database
Oropharyngeal cancer
Patients
postoperative radiation
Squamous cell carcinoma
Surgery
Survival
Throat cancer
Tumors
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Summary: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.
ISSN:1043-3074
1097-0347
DOI:10.1002/hed.25643