Is there a delay in treatment initiation of head and neck cancer patients in our country?

Czech version

Authors: M. Wzošová; M. Profant; Miroslav Tedla
Authors‘ workplace: Klinika otorinolaryngológie, chirurgie hlavy a krku LF UK a UNB, Bratislava
Published in: Otorinolaryngol Foniatr, 69, 2020, No. 2, pp. 70-74.
Category: Original Article

Overview

Introduction: Delay in treatment initiation of head and neck cancer patients is associated with progression of disease and shortened survival. In this work, we investigate if there is a treatment delay in head and neck cancer patients at our institution and if primary non-surgical treatment or management of patients at multiple institutions are associated with treatment delay.

Methods: In patients with newly diagnosed laryngeal cancer, treated at Department of Otolaryngology, Head and Neck Surgery, LFUK and UNB Bratislava between the years 2014 and 2018, time to treatment initiation (TTI) was calculated. Patients were divided into three groups according to TTI and risk of decreased survival: less than 45 days, 45 to 73 days and more than 73 days. Median TTI values and the number of patients in the three groups were compared between patients treated surgically and non-surgically and between patients managed only at our department and those sent with established diagnosis.

Results: Median TTI value in our cohort was 35 days. Twenty-eight percent of patients were in risk of delay, in 5% of patients there was a delay. Median TTI value in patients who were diagnosed and treated at our department was 13 days shorter than in patients who were sent to us with established diagnosis. There was a delay in treatment initiation of 13.51% non-surgically treated patients, 45.95% were in risk of delay.

Conclusion: There is a delay in treatment initiation of head and neck cancer patients. Waiting time is longer in patients managed at multiple institutions and in those treated non-surgically. It is necessary to work on decreasing it - by coordination of treatment in multidisciplinary team, centralisation of care, performance of biopsy at outpatient clinic, and in other ways.

Keywords:

head and neck cancer – Quality of care – treatment delay – time to treatment initiation – laryn-geal cancer

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