Association between the diagnosis-to-treatment interval and overall survival in Taiwanese patients with oral cavity squamous cell carcinoma

Chun Ta Liao, Hsin Ni Chen, Yu Wen Wen, Shu Ru Lee, Shu Hang Ng, Tsang Wu Liu, Sen Tien Tsai, Ming Hsui Tsai, Jin Ching Lin, Pei Jen Lou, Cheng Ping Wang, Pen Yuan Chu, Yi Shing Leu, Kuo Yang Tsai, Shyuang Der Terng, Tsung-Ming Chen, Cheng Hsu Wang, Chih Yen Chien, Wen Cheng Chen, Li Yu Lee & 9 others Chien Yu Lin, Hung Ming Wang, Chih Hung Lin, Tuan Jen Fang, Shiang Fu Huang, Chung Jan Kang, Kai Ping Chang, Lan Yan Yang, Tzu Chen Yen

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9 Citations (Scopus)

Abstract

Background To investigate the association between the diagnosis-to-treatment interval (DTI) and overall survival (OS) in patients with oral cavity squamous cell carcinoma (OSCC). Methods A total of 18,677 patients with first primary OSCC identified in the Taiwanese Cancer Registry Database between 2004 and 2010 were examined. The effect of DTI on 5-year OS rates was investigated with multivariate Cox regression analysis. After the identification of the optimal cutoff for DTI based on the 5-year OS rates, DTI was classified in the following 20-day groups: ≤20 days (57% of the study patients), 21–45 days (34%), 46–90 days (6%) and ≥91 days (3%). In additional exploratory analyses, DTI was reclassified in the following 30-day interval groups: ≤30 days (81% of the study patients), 31–60 days (14%), 61–90 days (2%) and ≥91 days (3%). Results Multivariate analyses identified DTI (≤20 days versus other subgroups), sex (female versus male), age (<65 versus ≥65 years), clinical stage (p-stage I versus p-stage II, III, IV) and treatment modality (initial surgery versus initial non-surgery) as independent prognostic factors for 5-year OS. Compared with a DTI ≤20 days, the DTI categories ≥91 days (hazard ratio [HR]: 1.28, P < 0.001), 46–90 days (HR: 1.25, P < 0.001) and 21–45 days (HR: 1.07, P = 0.007) were independently associated with a higher risk of 5-year mortality. Similar results were obtained for DTI ≤30 days groups. Conclusions DTI is independently associated with 5-year OS in OSCC patients. A DTI longer than 30 days or even 20 days may potentially decrease survival.

Original languageEnglish
Pages (from-to)226-234
Number of pages9
JournalEuropean Journal of Cancer
Volume72
DOIs
Publication statusPublished - Feb 1 2017

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Mouth
Squamous Cell Carcinoma
Survival
Therapeutics
Survival Rate
Registries
Multivariate Analysis
Regression Analysis
Databases
Mortality

Keywords

  • Cancer database
  • Diagnosis to treatment interval
  • Oral cavity squamous cell carcinoma
  • Outcome
  • Treatment delay

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Association between the diagnosis-to-treatment interval and overall survival in Taiwanese patients with oral cavity squamous cell carcinoma. / Liao, Chun Ta; Chen, Hsin Ni; Wen, Yu Wen; Lee, Shu Ru; Ng, Shu Hang; Liu, Tsang Wu; Tsai, Sen Tien; Tsai, Ming Hsui; Lin, Jin Ching; Lou, Pei Jen; Wang, Cheng Ping; Chu, Pen Yuan; Leu, Yi Shing; Tsai, Kuo Yang; Terng, Shyuang Der; Chen, Tsung-Ming; Wang, Cheng Hsu; Chien, Chih Yen; Chen, Wen Cheng; Lee, Li Yu; Lin, Chien Yu; Wang, Hung Ming; Lin, Chih Hung; Fang, Tuan Jen; Huang, Shiang Fu; Kang, Chung Jan; Chang, Kai Ping; Yang, Lan Yan; Yen, Tzu Chen.

In: European Journal of Cancer, Vol. 72, 01.02.2017, p. 226-234.

Research output: Contribution to journalArticle

Liao, CT, Chen, HN, Wen, YW, Lee, SR, Ng, SH, Liu, TW, Tsai, ST, Tsai, MH, Lin, JC, Lou, PJ, Wang, CP, Chu, PY, Leu, YS, Tsai, KY, Terng, SD, Chen, T-M, Wang, CH, Chien, CY, Chen, WC, Lee, LY, Lin, CY, Wang, HM, Lin, CH, Fang, TJ, Huang, SF, Kang, CJ, Chang, KP, Yang, LY & Yen, TC 2017, 'Association between the diagnosis-to-treatment interval and overall survival in Taiwanese patients with oral cavity squamous cell carcinoma', European Journal of Cancer, vol. 72, pp. 226-234. https://doi.org/10.1016/j.ejca.2016.11.010
Liao, Chun Ta ; Chen, Hsin Ni ; Wen, Yu Wen ; Lee, Shu Ru ; Ng, Shu Hang ; Liu, Tsang Wu ; Tsai, Sen Tien ; Tsai, Ming Hsui ; Lin, Jin Ching ; Lou, Pei Jen ; Wang, Cheng Ping ; Chu, Pen Yuan ; Leu, Yi Shing ; Tsai, Kuo Yang ; Terng, Shyuang Der ; Chen, Tsung-Ming ; Wang, Cheng Hsu ; Chien, Chih Yen ; Chen, Wen Cheng ; Lee, Li Yu ; Lin, Chien Yu ; Wang, Hung Ming ; Lin, Chih Hung ; Fang, Tuan Jen ; Huang, Shiang Fu ; Kang, Chung Jan ; Chang, Kai Ping ; Yang, Lan Yan ; Yen, Tzu Chen. / Association between the diagnosis-to-treatment interval and overall survival in Taiwanese patients with oral cavity squamous cell carcinoma. In: European Journal of Cancer. 2017 ; Vol. 72. pp. 226-234.
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abstract = "Background To investigate the association between the diagnosis-to-treatment interval (DTI) and overall survival (OS) in patients with oral cavity squamous cell carcinoma (OSCC). Methods A total of 18,677 patients with first primary OSCC identified in the Taiwanese Cancer Registry Database between 2004 and 2010 were examined. The effect of DTI on 5-year OS rates was investigated with multivariate Cox regression analysis. After the identification of the optimal cutoff for DTI based on the 5-year OS rates, DTI was classified in the following 20-day groups: ≤20 days (57{\%} of the study patients), 21–45 days (34{\%}), 46–90 days (6{\%}) and ≥91 days (3{\%}). In additional exploratory analyses, DTI was reclassified in the following 30-day interval groups: ≤30 days (81{\%} of the study patients), 31–60 days (14{\%}), 61–90 days (2{\%}) and ≥91 days (3{\%}). Results Multivariate analyses identified DTI (≤20 days versus other subgroups), sex (female versus male), age (<65 versus ≥65 years), clinical stage (p-stage I versus p-stage II, III, IV) and treatment modality (initial surgery versus initial non-surgery) as independent prognostic factors for 5-year OS. Compared with a DTI ≤20 days, the DTI categories ≥91 days (hazard ratio [HR]: 1.28, P < 0.001), 46–90 days (HR: 1.25, P < 0.001) and 21–45 days (HR: 1.07, P = 0.007) were independently associated with a higher risk of 5-year mortality. Similar results were obtained for DTI ≤30 days groups. Conclusions DTI is independently associated with 5-year OS in OSCC patients. A DTI longer than 30 days or even 20 days may potentially decrease survival.",
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author = "Liao, {Chun Ta} and Chen, {Hsin Ni} and Wen, {Yu Wen} and Lee, {Shu Ru} and Ng, {Shu Hang} and Liu, {Tsang Wu} and Tsai, {Sen Tien} and Tsai, {Ming Hsui} and Lin, {Jin Ching} and Lou, {Pei Jen} and Wang, {Cheng Ping} and Chu, {Pen Yuan} and Leu, {Yi Shing} and Tsai, {Kuo Yang} and Terng, {Shyuang Der} and Tsung-Ming Chen and Wang, {Cheng Hsu} and Chien, {Chih Yen} and Chen, {Wen Cheng} and Lee, {Li Yu} and Lin, {Chien Yu} and Wang, {Hung Ming} and Lin, {Chih Hung} and Fang, {Tuan Jen} and Huang, {Shiang Fu} and Kang, {Chung Jan} and Chang, {Kai Ping} and Yang, {Lan Yan} and Yen, {Tzu Chen}",
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TY - JOUR

T1 - Association between the diagnosis-to-treatment interval and overall survival in Taiwanese patients with oral cavity squamous cell carcinoma

AU - Liao, Chun Ta

AU - Chen, Hsin Ni

AU - Wen, Yu Wen

AU - Lee, Shu Ru

AU - Ng, Shu Hang

AU - Liu, Tsang Wu

AU - Tsai, Sen Tien

AU - Tsai, Ming Hsui

AU - Lin, Jin Ching

AU - Lou, Pei Jen

AU - Wang, Cheng Ping

AU - Chu, Pen Yuan

AU - Leu, Yi Shing

AU - Tsai, Kuo Yang

AU - Terng, Shyuang Der

AU - Chen, Tsung-Ming

AU - Wang, Cheng Hsu

AU - Chien, Chih Yen

AU - Chen, Wen Cheng

AU - Lee, Li Yu

AU - Lin, Chien Yu

AU - Wang, Hung Ming

AU - Lin, Chih Hung

AU - Fang, Tuan Jen

AU - Huang, Shiang Fu

AU - Kang, Chung Jan

AU - Chang, Kai Ping

AU - Yang, Lan Yan

AU - Yen, Tzu Chen

PY - 2017/2/1

Y1 - 2017/2/1

N2 - Background To investigate the association between the diagnosis-to-treatment interval (DTI) and overall survival (OS) in patients with oral cavity squamous cell carcinoma (OSCC). Methods A total of 18,677 patients with first primary OSCC identified in the Taiwanese Cancer Registry Database between 2004 and 2010 were examined. The effect of DTI on 5-year OS rates was investigated with multivariate Cox regression analysis. After the identification of the optimal cutoff for DTI based on the 5-year OS rates, DTI was classified in the following 20-day groups: ≤20 days (57% of the study patients), 21–45 days (34%), 46–90 days (6%) and ≥91 days (3%). In additional exploratory analyses, DTI was reclassified in the following 30-day interval groups: ≤30 days (81% of the study patients), 31–60 days (14%), 61–90 days (2%) and ≥91 days (3%). Results Multivariate analyses identified DTI (≤20 days versus other subgroups), sex (female versus male), age (<65 versus ≥65 years), clinical stage (p-stage I versus p-stage II, III, IV) and treatment modality (initial surgery versus initial non-surgery) as independent prognostic factors for 5-year OS. Compared with a DTI ≤20 days, the DTI categories ≥91 days (hazard ratio [HR]: 1.28, P < 0.001), 46–90 days (HR: 1.25, P < 0.001) and 21–45 days (HR: 1.07, P = 0.007) were independently associated with a higher risk of 5-year mortality. Similar results were obtained for DTI ≤30 days groups. Conclusions DTI is independently associated with 5-year OS in OSCC patients. A DTI longer than 30 days or even 20 days may potentially decrease survival.

AB - Background To investigate the association between the diagnosis-to-treatment interval (DTI) and overall survival (OS) in patients with oral cavity squamous cell carcinoma (OSCC). Methods A total of 18,677 patients with first primary OSCC identified in the Taiwanese Cancer Registry Database between 2004 and 2010 were examined. The effect of DTI on 5-year OS rates was investigated with multivariate Cox regression analysis. After the identification of the optimal cutoff for DTI based on the 5-year OS rates, DTI was classified in the following 20-day groups: ≤20 days (57% of the study patients), 21–45 days (34%), 46–90 days (6%) and ≥91 days (3%). In additional exploratory analyses, DTI was reclassified in the following 30-day interval groups: ≤30 days (81% of the study patients), 31–60 days (14%), 61–90 days (2%) and ≥91 days (3%). Results Multivariate analyses identified DTI (≤20 days versus other subgroups), sex (female versus male), age (<65 versus ≥65 years), clinical stage (p-stage I versus p-stage II, III, IV) and treatment modality (initial surgery versus initial non-surgery) as independent prognostic factors for 5-year OS. Compared with a DTI ≤20 days, the DTI categories ≥91 days (hazard ratio [HR]: 1.28, P < 0.001), 46–90 days (HR: 1.25, P < 0.001) and 21–45 days (HR: 1.07, P = 0.007) were independently associated with a higher risk of 5-year mortality. Similar results were obtained for DTI ≤30 days groups. Conclusions DTI is independently associated with 5-year OS in OSCC patients. A DTI longer than 30 days or even 20 days may potentially decrease survival.

KW - Cancer database

KW - Diagnosis to treatment interval

KW - Oral cavity squamous cell carcinoma

KW - Outcome

KW - Treatment delay

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U2 - 10.1016/j.ejca.2016.11.010

DO - 10.1016/j.ejca.2016.11.010

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VL - 72

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EP - 234

JO - European Journal of Cancer

JF - European Journal of Cancer

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