Delays to treatment initiation in the management of head and neck cancer

Connell, James Thomas; Sekhar, Vimal; Hodge, John-Charles; Krishnan, Surendranath; Foreman, Andrew

doi:10.21037/ajo.2020.02.01

Cited by 2 publications

(3 citation statements)

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“…The duration between the definitive treatment decision and the commencement of treatment could also affect the timeliness of HNC management. Although our duration was consistent with previous Australian studies, 17,18 a recent Dutch study had reduced this period to 21 days. 33 Factors which may reduce delays in the commencement of treatment would include the frequency of HNC operating lists, dedicated HNC nurse coordinators, and the availability of all modalities of treatment within a health service, which are all limited by resources available to the health service.…”

Section: "]supporting

confidence: 90%

“…Head and neck malignancies affect over 5000 people every year in Australia 1 and the timeliness of its management can have significant effects on a patient's staging, treatment options, prognosis and quality of life. Although previous Australian and international studies identified various factors affecting timeliness in management, [10][11][12]17 this is the largest Australian study analysing a number of patient factors such as socioeconomic background.…”

Section: Discussionmentioning

confidence: 99%

“…Although previous studies had assessed the patient and physician factors associated with diagnostic delays, 12,15,16 including previous smaller Australian studies, 17,18 socioeconomic factors had not been analysed in Australian health systems. The primary objective of this study was to identify associations between patient factors including demographic and social factors, as well as referrer and treating team factors affecting timeliness in management.…”

Section: Introductionmentioning

confidence: 99%

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Factors affecting timeliness in management of head and neck cancer

Kwok

Wong

Prasad

2023

ANZ Journal of Surgery

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BackgroundTimeliness in the management of patients with head and neck cancer (HNC) can be affected by both patient and non‐patient related factors. This study aims to investigate the factors associated with the timeliness of managing HNC.MethodsA retrospective review was conducted on Western Health medical records including all new patients presenting to the Western Health HNC surgical outpatient clinic in the five‐year period from first January 2017 to 31st December 2021 with the diagnosis of a HNC. Both patient and non‐patient related factors were compared with the duration between a patient's referral to a HNC service and the commencement of their treatment.ResultsTwo hundred and twenty‐eight patients were included in this study. The median duration from referral to the commencement of treatment was 48 days. Lack of radiological or pathological investigations prior to referral to a HNC service as well as early staging were found to significantly impact timeliness in management. Socioeconomic factors such as non‐English speaking backgrounds, distance from the hospital and lack of social supports were not found to negatively impact timeliness of management.ConclusionThe management of patients with HNC require careful consideration of all patient and non‐patient related factors which may affect timeliness in management, particularly investigations performed prior to their referral to a HNC service.

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Section: "]supporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Factors affecting timeliness in management of head and neck cancer

Kwok

Wong

Prasad

2023

ANZ Journal of Surgery

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Delays in Time to Head and Neck Cancer Treatment: A South Australian Perspective

Cook¹,

Woods

Nicholls

et al. 2022

Medicina

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Background and Objectives: In head and neck cancer, delays in time to treatment are associated with poorer clinical outcomes. Within Australia, it is recommended that primary treatment is initiated within 56 days of initial referral. The aim of this study was to assess whether head and neck cancer treatment was delivered within these timeframe guidelines at our institution and identify factors associated with treatment delays. Methods: This retrospective cohort study assessed patients newly diagnosed with head and neck cancer over a 24 months period (2018 to 2019) at Flinders Medical Centre, Australia. Time to treatment intervals were calculated for comparison to local timeframe guidelines. Results: A total of 72 patients met the inclusion criteria. The median time from specialist referral to treatment initiation was 45.5 days (IQR 29–61), with 72% meeting the 56 days guideline. On univariate logistic regression, patients undergoing primary radiotherapy treatment were less likely to meet this guideline than those undergoing primary surgery (OR 8.8, 95% CI 2.6–28.9, p < 0.001), as were those requiring prophylactic gastrostomy tube insertion (OR 3.1, 95% CI 1.1–9.0, p < 0.05). Treatment initiation beyond 56 days had no significant impact on 12 months overall survival or disease-free survival. Conclusions: The findings of this study demonstrate that primary radiotherapy treatment is associated with delays in head and neck cancer treatment initiation, likely related to time consuming pre-treatment factors such as gastrostomy tube insertion.

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Delays to treatment initiation in the management of head and neck cancer

Cited by 2 publications

References 4 publications

Factors affecting timeliness in management of head and neck cancer

Factors affecting timeliness in management of head and neck cancer

Delays in Time to Head and Neck Cancer Treatment: A South Australian Perspective

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