PMID- 29756382
OWN - NLM
STAT- MEDLINE
DCOM- 20190325
LR  - 20210503
IS  - 1531-4995 (Electronic)
IS  - 0023-852X (Linking)
VI  - 128
IP  - 12
DP  - 2018 Dec
TI  - Treatment delays in laryngeal squamous cell carcinoma: A national cancer database 
      analysis.
PG  - 2751-2758
LID - 10.1002/lary.27247 [doi]
AB  - OBJECTIVE: To characterize treatment delays in laryngeal cancer and associate 
      delays with patient, tumor, and treatment factors and with overall survival. 
      METHODS: We identified 33,819 adults with laryngeal squamous cell carcinoma 
      (LSCC) in the National Cancer Database from 2004 to 2013. We calculated durations 
      of diagnosis-to-treatment initiation, surgery-to-adjuvant treatment, radiotherapy 
      duration, total treatment package, and diagnosis-to-treatment end intervals. 
      Delays were associated with patient, tumor, and treatment characteristics via 
      multivariable logistic regression and with overall survival by Cox proportional 
      hazards regression. RESULTS: Median durations of diagnosis-to-treatment 
      initiation, surgery-to-radiation initiation, radiation treatment, total treatment 
      package, and diagnosis-to-treatment end were 28, 42, 48, 91, and 107 days in 
      surgical patients; median durations of diagnosis-to-treatment initiation, 
      radiation treatment, and diagnosis-to-treatment end were 33, 50, and 85 days in 
      nonsurgical patients. Race and insurance status were linked to delays in most 
      intervals. Academic and high-volume facilities had less delayed radiation 
      treatment but increased delays in most other intervals. Delayed 
      surgery-to-radiation and total treatment package intervals were associated with 
      overall survival in surgical patients (hazard ratio [HR] = 1.15 [1.03-1.29], 
      P = 0.015; HR = 1.16 [1.02-1.31], P = 0.025). Diagnosis-to-treatment initiation 
      and diagnosis-to-treatment end intervals were associated with overall survival in 
      nonsurgical patients (HR = 1.08 [1.02-1.14], P = 0.007; HR = 1.09 [1.03-1.16], 
      P = 0.003, respectively) but not in surgical patients (HR = 0.96 [0.87-1.06] 
      P = 0.440; HR = 1.13 [0.99-1.29], P = 0.062). Radiation delays were associated 
      with overall survival in surgical and nonsurgical patients (HR = 1.21 
      [1.09-1.36], P = 0.001; HR = 1.37 [1.30-1.44], P < 0.001). CONCLUSION: These 
      durations can serve as national benchmarks. Delays could be considered quality 
      indicators in LSCC. LEVEL OF EVIDENCE: 2b Laryngoscope, 128:2751-2758, 2018.
CI  - (c) 2018 The American Laryngological, Rhinological and Otological Society, Inc.
FAU - Morse, Elliot
AU  - Morse E
AUID- ORCID: 0000-0001-8893-805X
AD  - Department of Surgery, Division of Otolaryngology, Yale University School of 
      Medicine, New Haven, Connecticut, U.S.A.
FAU - Fujiwara, Rance J T
AU  - Fujiwara RJT
AUID- ORCID: 0000-0002-1033-2397
AD  - Department of Surgery, Division of Otolaryngology, Yale University School of 
      Medicine, New Haven, Connecticut, U.S.A.
FAU - Judson, Benjamin
AU  - Judson B
AUID- ORCID: 0000-0002-0771-4220
AD  - Department of Surgery, Division of Otolaryngology, Yale University School of 
      Medicine, New Haven, Connecticut, U.S.A.
FAU - Mehra, Saral
AU  - Mehra S
AD  - Department of Surgery, Division of Otolaryngology, Yale University School of 
      Medicine, New Haven, Connecticut, U.S.A.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20180514
PL  - United States
TA  - Laryngoscope
JT  - The Laryngoscope
JID - 8607378
SB  - IM
MH  - Carcinoma, Squamous Cell/diagnosis/mortality/*therapy
MH  - Combined Modality Therapy
MH  - Disease-Free Survival
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Laryngeal Neoplasms/diagnosis/mortality/*therapy
MH  - Male
MH  - Middle Aged
MH  - *Neoplasm Staging
MH  - Retrospective Studies
MH  - Survival Rate/trends
MH  - Time Factors
MH  - Time-to-Treatment/*trends
MH  - United States/epidemiology
OTO - NOTNLM
OT  - Head and neck cancer
OT  - laryngeal squamous cell carcinoma
OT  - quality of care
OT  - radiotherapy
OT  - surgery
EDAT- 2018/05/15 06:00
MHDA- 2019/03/26 06:00
CRDT- 2018/05/15 06:00
PHST- 2018/02/09 00:00 [received]
PHST- 2018/03/13 00:00 [revised]
PHST- 2018/03/29 00:00 [accepted]
PHST- 2018/05/15 06:00 [pubmed]
PHST- 2019/03/26 06:00 [medline]
PHST- 2018/05/15 06:00 [entrez]
AID - 10.1002/lary.27247 [doi]
PST - ppublish
SO  - Laryngoscope. 2018 Dec;128(12):2751-2758. doi: 10.1002/lary.27247. Epub 2018 May 
      14.