Treatment delay in early-stage oral squamous cell carcinoma and its relation to survival |
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| Authors: | Karl Metzger Julius Moratin Dominik Horn Maximilian Pilz Oliver Ristow Jürgen Hoffmann Kolja Freier Michael Engel Christian Freudlsperger |
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| Affiliation: | 1. Heidelberg University Hospital, Department of Oral and Cranio-Maxillofacial Surgery, Im Neuenheimer Feld 400, D-69120, Heidelberg, Germany;2. Saarland University Hospital, Department of Oral and Cranio-Maxillofacial Surgery, Kirrberger Str. 100, D-66421, Homburg, Germany;3. Institute of Medical Biometry and Informatics, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, D-69120, Heidelberg, Germany;1. Istanbul Medipol University, School of Dentistry, Department of Oral and Maxillofacial Surgery, ?stanbul Medipol Üniversitesi, Di? Hekimli?i Fakültesi, Esenler Hastanesi, Birlik Mah. Bahçeler Cad. No: 5 Esenler, ?stanbul, Turkey;2. Istanbul Medipol University, School of Dentistry, Department of Oral and Maxillofacial Surgery, Medipol University School of Dentistry, TEM Avrupa Otoyolu Go¨ztepe Ç?k??? No: 1 Ba?c?lar, 34214, ?stanbul, Turkey;1. Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan;2. Department of Otolaryngology, Shimane University Faculty of Medicine, Izumo, Shimane, Japan;3. Department of Plastic and Reconstructive Surgery, Shimane University Hospital, Izumo, Shimane, Japan;1. Department of Maxillofacial Surgery, ZMACK Association, University Hospital of Antwerp, Edegem, Belgium;2. Division of Maxillofacial Surgery, Department of Paediatric Surgery, Hospital Sant Joan de Deu, Esplugues de Llobregat, Barcelona, Spain;3. Division of Paediatric Maxillofacial Surgery, Department of Paediatric Surgery, Hospital Sant Joan de Deu, Barcelona Children''s Hospital, Esplugues de Llobregat, Barcelona, Spain;4. Department of Maxillofacial Surgery, All for Research VZW, ZMACK Association, AZ MONICA Antwerp, Antwerp, Belgium;5. Department of Neurosurgery, University Hospital Antwerp, Edegem, Belgium;6. Department of Plastic Surgery, Great Ormond Street Hospital for Children, Great Ormond Street, London, WC1N 3JH, United Kingdom;7. Faculty of Medicine & Health Sciences, University of Antwerp, Campus Drie Eiken, Universiteits-plein 1, 2610 Antwerp, Belgium;1. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Oral Maxillofacial Surgery, West China School of Stomatology, Sichuan University, Chengdu, 610041, China;2. Department of Health Statistics, School of Preventive Medicine, Fourth Military Medical University, Changlexilu Road #169, Shaanxi, 710032, China;3. Division of Plastic Surgery, The Children''s Hospital of Philadelphia, Philadelphia, PA, 19104, USA |
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| Abstract: | The aim of this study was to investigate the impact of a prolonged treatment delay on survival in patients with primary oral squamous cell carcinoma. The investigators hypothesized that treatment delay affects survival, supposing a poor outcome in patients with prolonged treatment initiation. In addition, a critical treatment delay should be defined.Inclusion criteria were a histopathological diagnosis of primary squamous cell carcinoma of the oral cavity and a surgery-based treatment of the tumor. Patients with a history of previously diagnosed malignancies and patients with distant metastasis at the time of diagnosis were excluded from this protocol. Common clinical and histopathological data were assessed retrospectively. Treatment delay was analyzed for the interval between initial presentation and the date of surgery.A total of 484 patients could be included. Considering early-stage patients, the risk of death increases by 1.8% for each day that the treatment delay is prolonged if all other characteristics do not change (p = 0.0035). In patients with advanced disease, a prolonged treatment delay does not affect the risk of death (p = 0.9134). In terms of progression-free survival, treatment delay tends to be associated with a higher risk of recurrence in early-stage disease, but without being statistically significant (p = 0.0718). For patients with early-stage disease, a treatment delay of 20 days is critical regarding overall survival (p = 0.011). For patients with advanced-stage disease, no significant differences have been observed.As patients with early-stage oral squamous cell carcinoma profit from early treatment initiation, we suggest an acceptable maximum treatment delay of no more than 20 days in the surgical management of these patients. |
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| Keywords: | Oral squamous cell carcinoma Head and neck cancer Treatment delay Survival |
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