Time untill the first treatment of the head and neck cancer and a better evaluation of the initial symptoms are key points for a better control of the tumor and survival rates. The present study evaluates the waiting time since diagnosis and the respective treatments.
A retrospective study was developed based on data collection from the clinical files of four institutions of the North of Portugal. A total of patients (n = 179) diagnosed with head and neck cancer between January 2012 and December 2012 in these institutions were evaluated.
In the study group, the median age at diagnosis was 60 years (range: 17-93) and 70.4% of patients had an age below 65 years. The most common stage at diagnosis was stage IVa (36%). The median time from diagnosis to first treatment was 40.5 days (range:0-170). The most common treatment was surgery (45.09%) followed by radiotherapy (23.7%). The waiting time until the first treatment was lower in patients undergoing surgery (median days 27, range: 0-150) followed by chemotherapy group (days 48, range: 5-60), while radiotherapy had the highest waiting time (62, range: 4- 170). The median time to the first treatment was lower in the less advanced stages (stage ≤ III: 37 days, range: 0-170) when compared to advanced stages (45 days, range: 0-157). The estimated overall survival was 36.44 months (30.1% of events).
In 2012 the waiting time to the initial treatment of the head and neck cancer was above the standard values suggested by the General Health Direction in Portugal. Patients with more advanced stages, usually undergo chemo and radiotherapy, so, its time to the initial treatment is superior to patients undergoing surgery. Delays in radio and chemotherapy may be related to the placement of venous central catheter and dental treatments that patients needed before start treatment. These delays are an important issue because in patients with advanced stages the risk of dissemination of the tumor is higher compare to those with localized stages. As the best of our knowledge this is the first study regarding the waiting time in Portugal. The authors intend to compare these data with the year of 2015, since it was implemented a new national guidance.
Clinical trial identification
Legal entity responsible for the study
CHP, CHTMAD, CHEDV, CHVNG
All authors have declared no conflicts of interest.