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. 2024 Jun 29;14(4):1270-1284.
doi: 10.3390/clinpract14040103.

Time-to-Treatment Delays and Their Prognostic Implications in Pharyngeal Cancer-An Exploratory Analysis in Western Romania

Andreea Mihaela Kiș  1   2 , Roxana Buzatu  3 , Lazar Chisavu  4 , Marioara Poenaru  5 , Claudia Borza  6   7 , Andrada Iftode  1   2 , Oana Silvana Sarau  8 , Cristina Adriana Dehelean  1   2 , Simona Ardelean  9
Affiliations

Time-to-Treatment Delays and Their Prognostic Implications in Pharyngeal Cancer-An Exploratory Analysis in Western Romania

Andreea Mihaela Kiș et al. Clin Pract. .

Abstract

Background: Diagnosis and treatment for pharyngeal cancer are decisive in determining prognosis. Diagnosis delays are frequent, representing a significant cause of avoidable mortality, and an important factor in subpar survival across the continuous HNC care delivery.

Methods: The present study represents a retrospective analysis of medical records from Western Romania, which included 180 patients, to evaluate the impact of time-to-treatment delay on patients diagnosed with pharyngeal cancer. The data analyses were performed using the Kaplan-Meier method R (version 3.6.3) packages, including tidyverse, final-fit, mcgv, survival, stringdist, janitor, and Hmisc.

Results: The mean days from diagnosis until the end of treatment were higher for the nasopharynx group. Cox regression analysis regarding diagnosis to treatment duration categories showed an increased risk mortality by 3.11 times (95%CI: 1.51-6.41, p = 0.0021) with a Harrell's C-index of 0.638 (95%CI: 0.552-0.723). The hypopharynx and oropharynx locations increased risk mortality by 4.59 (95%CI: 1.55-13.55) and 5.49 times (95%CI: 1.79-16.81) compared to the nasopharynx location.

Conclusions: The findings of this study led to the conclusion that it seems there is a trend of mortality risk for oropharynx and hypopharynx cancers due to delays in the time to treatment over 70 days, standing as a basis for further research as there is an imperative need for prospective multicenter studies.

Keywords: delayed diagnosis; overall survival; pharyngeal cancer; time to treatment.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Survival probability of death.
Figure 2
Figure 2
The Kaplan–Meier survival curve in the risk of death, stratified by the location of the neoplasia.
Figure 3
Figure 3
Graphical representation of the Kaplan–Meier survival curve on the risk of death for (a) treatment duration groups and (b) diagnostic to treatment days groups.
Figure 4
Figure 4
The Cox regression analysis regarding risk mortality.
See this image and copyright information in PMC

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