#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Association between hospital interval and survival in patients with oral cancer: A waiting time paradox


Autoři: José Luis Lopez-Cedrún aff001;  Ana Otero-Rico aff001;  Inés Vázquez-Mahía aff001;  Juan Seoane aff002;  Lucía García-Caballero aff002;  Juan Manuel Seoane-Romero aff003;  Pablo Varela-Centelles aff004
Působiště autorů: Service of Oral and Maxillofacial Surgery, A Coruña University Hospital (CHUAC), Galician Health Service, A Coruña, Spain aff001;  Department of Surgery and Medical-Surgical Specialities, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain aff002;  Department of Surgery and Medical-Surgical Specialities, School of Medicine and Health Sciences, University of Oviedo, Oviedo, Spain aff003;  Praza do Ferrol Health Centre, EOXI Lugo, Cervo e Monforte de Lemos, Galician Health Service, Lugo, Spain aff004
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0224067

Souhrn

Background

In early diagnosis studies on symptomatic cancer, survival was the most recommended outcome. The magnitude and impact of the patient interval and primary care interval is well-known in oral cancer; however, the hospital interval and its influence on surviving this neoplasia are not well known.

Aims

To quantify the interval between the first contact with the specialist and the start of treatment for patients with oral cancer and to evaluate whether there was a link between this interval and disease survival.

Methods

We designed a hospital-based study that included 228 patients diagnosed with oral/oropharyngeal squamous cell carcinoma between 1998 and 2008 at A Coruña University Hospital (Spain) who were followed up until 2016. The data were extracted retrospectively from hospital medical charts. The study interval was defined in the context of the "pathways to treatment" model as the interval from the first specialist visit (start point) to the start of treatment (end point). We calculated the total interval (from first symptom to treatment) to evaluate the relative length of the hospital interval, and we considered the variables age, sex, location, comorbidity and tumour classification stage. Survival time was defined as the interval from the first treatment to death or censoring.

Results

The median hospital interval was 20 days, with an interquartile range of 15–29.1 days. The most relevant prognostic variable was the tumour stage (III-IV: Exp. ß = 2.8, p = 0.001). The hospital interval was part of the multivariate model, and its association with mortality showed a V-shaped association, where patients with short hospital intervals (3–18 days) and those with long hospital intervals (26–55 days) had significantly higher mortality than those with medium hospital intervals (19–25 days).

Conclusion

The hospital interval represents a relevant interval for the patient’s path towards treatment, has prognostic implications and is subject to a severity bias (waiting time paradox) that should be avoided.

Klíčová slova:

Cancer detection and diagnosis – Cancer treatment – Diagnostic medicine – Oncology – Primary care – Surgical and invasive medical procedures – Surgical oncology – Dental and oral procedures


Zdroje

1. Warnakulasuriya S. Global epidemiology of oral and oropharyngeal cancer. Oral Oncol 2009;45:(4–5)309–316. doi: 10.1016/j.oraloncology.2008.06.002 18804401

2. Warnakulasuriya S. Living with oral cancer: epidemiology with particular reference to prevalence and life-style changes that influence survival. Oral Oncol 2010; 46(6):407–410. doi: 10.1016/j.oraloncology.2010.02.015 20403722

3. Gupta B, Johnson NW, Kumar N. Global Epidemiology of Head and Neck Cancers: A Continuing Challenge. Oncology. 2016;91(1):13–23. doi: 10.1159/000446117 27245686

4. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018 Nov;68(6):394–424. doi: 10.3322/caac.21492 30207593

5. Gao W, Guo CB. Factors related to delay in diagnosis of oral squamous cell carcinoma. J Oral Maxillofac Surg. 2009 May;67(5):1015–20. doi: 10.1016/j.joms.2008.12.022 19375011

6. Silverman S, Kerr AR, Epstein JB. Oral and pharyngeal cancer control and early detection. J Canc Educ 2010;25(3):279–281. doi: 10.1007/s13187-010-0045-6 20204575

7. Neal RD, Tharmanathan P, France B, Din NU, Cotton S, Fallon-Ferguson J, et al. Is increased time to diagnosis and treatment in symptomatic cancer associated with poorer outcomes? Systematic review. Br J Cancer. 2015 Mar 31;112 Suppl 1:S92–107. doi: 10.1038/bjc.2015.48 25734382

8. Seoane J, Takkouche B, Varela-Centelles P, Tomás I, Seoane-Romero JM. Impact of delay in diagnosis on survival to head and neck carcinomas: a systematic review with meta-analysis. Clin Otolaryngol. 2012 Apr;37(2):99–106. doi: 10.1111/j.1749-4486.2012.02464.x 22429704

9. Weller D, Vedsted P, Rubin G, Walter FM, Emery J, Scott S, et al. The Aarhus statement: improving design and reporting of studies on early cancer diagnosis. Br J Cancer. 2012 Mar 27; 106(7): 1262–1267. doi: 10.1038/bjc.2012.68 22415239

10. Coxon D, Campbell C, Walter FM, Scott SE, Neal RD, Vedsted P, et al. The Aarhus statement on cancer diagnostic research: turning recommendations into new survey instruments. BMC Health Serv Res. 2018 Sep 3;18(1):677. doi: 10.1186/s12913-018-3476-0 30176861

11. Seoane J, Alvarez-Novoa P, Gomez I, Takkouche B, Diz P, Warnakulasiruya S, et al. Early oral cancer diagnosis: The Aarhus statement perspective. A systematic review and meta-analysis. Head Neck. 2015 Mar 17. doi: 10.1002/hed.24050 25783770

12. Varela-Centelles P, López-Cedrún JL, Fernández-Sanromán J, Seoane-Romero JM, Santos de Melo N, Álvarez-Nóvoa P, et al. Key points and time intervals for early diagnosis in symptomatic oral cancer: a systematic review. Int J Oral Maxillofac Surg. 2017 Jan;46(1):1–10. doi: 10.1016/j.ijom.2016.09.017 27751768

13. Allgar VL, Neal RD. Delays in the diagnosis of six cancers: analysis of data from the National Survey of NHS Patients: Cancer. Br J Cancer. 2005 Jun 6;92(11):1959–1970. doi: 10.1038/sj.bjc.6602587 15870714

14. Morelatto RA, Herrera MC, Fernández EN, Corball AG, López de Blanc SA. Diagnostic delay of oral squamous cell carcinoma in two diagnosis centers in Córdoba Argentina. J Oral Pathol Med 2007;36(7):405–408. doi: 10.1111/j.1600-0714.2007.00547.x 17617833

15. Williams RG. The early diagnosis of carcinoma of the mouth. Ann R Coll Surg Engl. 1981 Nov;63(6):423–5 7294687

16. Scully C, Malamos D, Levers BG, Porter SR, Prime SS. Sources and patterns of referrals of oral cancer: role of general practitioners. Br Med J (Clin Res Ed). 1986 Sep 6;293(6547):599–601. doi: 10.1136/bmj.293.6547.599 3092946

17. Abdo EN, Garrocho Ade A, Barbosa AA, Oliveira EL, Franca-Filho L, Negri SL, et al. Time elapsed between the first symptoms, diagnosis and treatment of oral cancer patients in Belo Horizonte, Brazil. Med Oral Patol Oral Cir Bucal 2007;12(7): E469 –E473 17978768

18. Olesen F, Hansen RP, Vedsted P. Delay in diagnosis: the experience in Denmark. Br J Cancer 2009;101: S5—S8. doi: 10.1038/sj.bjc.6605383 19956163

19. Seoane J, Pita-Fernández S, Gómez I, Vazquez I, López-Cedrún JL, De Agustin D, et al. Proliferative activity and diagnostic delay in oral cancer Head Neck 2010;32(10): 1377–1384. doi: 10.1002/hed.21338 20091693

20. Tørring ML, Frydenberg M, Hansen RP, Olesen F, Vedsted P. Evidence of increasing mortality with longer diagnostic intervals for five common cancers: A cohort study in primary care. Eur J Cancer 2013;49(9):2187–2198 doi: 10.1016/j.ejca.2013.01.025 23453935

21. van der Waal I, de Bree R, Brakenhoff R, Coebergh JW. Early diagnosis in primary oral cancer: is it possible? Med Oral Patol Oral Cir Bucal 2011;16(3): e300 –e305. doi: 10.4317/medoral.16.e300 21441877

22. Goy J, Hall SF, Feldman-Stewart D, Groome PA. Diagnostic delay and disease stage in head and neck cancer: a systematic review. Laryngoscope. 2009 May;119(5):889–98. doi: 10.1002/lary.20185 19301409

23. Gómez I, Seoane J, Varela-Centelles P, Diz P, Takkouche B. Is diagnostic delay related to advanced-stage oral cancer? A meta-analysis. Eur J Oral Sci 2009;117(5): 541–546. doi: 10.1111/j.1600-0722.2009.00672.x 19758250

24. Varela-Centelles P, Seoane J, Lopez-Cedrun JL, Fernandez-Sanroman J, García-Martin JM, Takkouche B, et al. The length of patient and primary care time interval in the pathways to treatment in symptomatic oral cancer. A quantitative systematic review. Clin Otolaryngol. 2018 Feb;43(1):164–171. doi: 10.1111/coa.12919 28627802

25. Lyratzopoulos G, Abel GA, McPhail S, Neal RD, Rubin GP. Measures of promptness of cancer diagnosis in primary care: secondary analysis of national audit data on patients with 18 common and rarer cancers. Br J Cancer. 2013 Feb 19;108(3):686–90. doi: 10.1038/bjc.2013.1 23392082

26. Liao CT, Chen HN, Wen YW, Lee SR, Ng SH, Liu TW, et al. Association between the diagnosis-to-treatment interval and overall survival in Taiwanese patients with oral cavity squamous cell carcinoma. Eur J Cancer. 2017 Feb;72:226–234. doi: 10.1016/j.ejca.2016.11.010 28056426

27. Tsai WC, Kung PT, Wang YH, Huang KH, Liu SA. Influence of time interval from diagnosis to treatment on survival for oral cavity cancer: A nationwide cohort study. PLoS One. 2017 Apr 7;12(4):e0175148. doi: 10.1371/journal.pone.0175148 28388649

28. Chen MM, Harris JP, Orosco RK, Sirjani D, Hara W, Divi V. Association of Time between Surgery and Adjuvant Therapy with Survival in Oral Cavity Cancer. Otolaryngol Head Neck Surg. 2018 Jun;158(6):1051–1056. doi: 10.1177/0194599817751679 29313448

29. Fujiwara RJ, Judson BL, Yarbrough WG, Husain Z, Mehra S. Treatment delays in oral cavity squamous cell carcinoma and association with survival. Head Neck. 2017 Apr;39(4):639–646. doi: 10.1002/hed.24608 28236349

30. Chiou SJ, Lin W, Hsieh CJ. Assessment of duration until initial treatment and its determining factors among newly diagnosed oral cancer patients: A population-based retrospective cohort study. Medicine (Baltimore). 2016 Dec;95(50):e5632.

31. Kyriacou DN, Lewis RJ. Confounding by Indication in Clinical Research. JAMA. 2016 Nov 1;316(17):1818–1819. doi: 10.1001/jama.2016.16435 27802529

32. Seoane J, Otero-Rico A, López-Cedrún JL, Varela-Centelles P. Shorter specialist time intervals are associated with advanced stage on symptomatic oral cancer. Oral Dis. 2018 Mar;24(1–2):112–114. doi: 10.1111/odi.12754 29480638

33. Murphy CT, Galloway TJ, Handorf EA, Egleston BL, Wang LS, Mehra R, et al. Survival Impact of Increasing Time to Treatment Initiation for Patients With Head and Neck Cancer in the United States. J Clin Oncol. 2016 Jan 10;34(2):169–78. doi: 10.1200/JCO.2015.61.5906 26628469

34. Symonds RP. Cancer biology may be more important than diagnostic delay. BMJ. 2002 Oct 5;325(7367):774. 12364310

35. Aggarwal A, Herz N, Campbell P, Arkush L, Short S, Rees J. Diagnostic delay and survival in high-grade gliomas—evidence of the ‘waiting time paradox’? Br J Neurosurg. 2015;29(4):520–3. doi: 10.3109/02688697.2015.1012050 25738427

36. Tørring ML, Frydenberg M, Hamilton W, Hansen RP, Lautrup MD, Vedsted P. Diagnostic interval and mortality in colorectal cancer: U-shaped association demonstrated for three different datasets. J Clin Epidemiol. 2012 Jun;65(6):669–78. doi: 10.1016/j.jclinepi.2011.12.006 22459430 Epub 2012 Mar 27.

37. Polesel J, Furlan C, Birri S, Giacomarra V, Vaccher E, Grando G, et al. The impact of time to treatment initiation on survival from head and neck cancer in north-eastern Italy. Oral Oncol. 2017 Apr;67:175–182. doi: 10.1016/j.oraloncology.2017.02.009 28351574

38. van Huizen LS, Dijkstra PU, van der Laan BFAM, Reintsema H, Ahaus KTB, Bijl HP, et al. Multidisciplinary first-day consultation accelerates diagnostic procedures and throughput times of patients in a head-and-neck cancer care pathway, a mixed method study. BMC Health Serv Res. 2018 Oct 29;18(1):820. doi: 10.1186/s12913-018-3637-1 30373578


Článek vyšel v časopise

PLOS One


2019 Číslo 10
Nejčtenější tento týden
Nejčtenější v tomto čísle
Kurzy

Zvyšte si kvalifikaci online z pohodlí domova

KOST
Koncepce osteologické péče pro gynekology a praktické lékaře
nový kurz
Autoři: MUDr. František Šenk

Sekvenční léčba schizofrenie
Autoři: MUDr. Jana Hořínková

Hypertenze a hypercholesterolémie – synergický efekt léčby
Autoři: prof. MUDr. Hana Rosolová, DrSc.

Svět praktické medicíny 5/2023 (znalostní test z časopisu)

Imunopatologie? … a co my s tím???
Autoři: doc. MUDr. Helena Lahoda Brodská, Ph.D.

Všechny kurzy
Kurzy Podcasty Doporučená témata Časopisy
Přihlášení
Zapomenuté heslo

Zadejte e-mailovou adresu, se kterou jste vytvářel(a) účet, budou Vám na ni zaslány informace k nastavení nového hesla.

Přihlášení

Nemáte účet?  Registrujte se

#ADS_BOTTOM_SCRIPTS#