Long interval from diagnosis to treatment tied to poor outcomes in OCSSC
A long interval between the confirmation of malignancy and the initiation of first treatment appears to be associated with a higher risk of death in patients with oral cavity squamous cell carcinoma (OCSSC), a new study shows.
The study retrieved the records of 21,263 patients with oral cavity cancers or SCC from the National Health Insurance Research Database of Taiwan. Those with multiple primary cancers, who had distant metastases, who died within 1 month and with incomplete information were excluded.
The time from diagnosis to the initiation of the first treatment was determined from the medical records. The primary outcome of the study was overall survival and the duration of follow-up was from diagnosis until death or withdrawal.
The average age at diagnosis was 53.5±12.0 years, and the average time interval from diagnosis to treatment was 24.3±76.3 days. Tongue cancer (35.9 percent) was the most common cancer type. Lip, gum and mouth floor cancers (19.9 percent), and cancers of the palate, buccal mucosa and unspecified sites (44.1 percent) were also reported.
The most common first treatment was surgery (93.1 percent), followed by radiotherapy (4.7 percent) and chemotherapy (2.2 percent). Only 2,498 (11.8 percent) and 572 patients (2.7 percent) received treatment between 31 and 120 days, and 120 days after diagnosis, respectively. The vast majority (85.6 percent) received treatment within 30 days.
There was a significant difference between the number of survivors (n=12,417) and that of deaths (n=8,846; p<0.001). Patients who received treatment within 30 days had a higher survival rate than those treated after 120 days (60.4 vs 35.8 percent).
Finally, patients who received treatment after 120 days are 1.32 (95 percent CI, 1.19 to 1.47) times more at risk of death compared with those who received treatment within 30 days.