Impact of Time to Diagnosis and Treatment in Head and Neck Cancer: A Systematic Review

Otolaryngology - Head and Neck Surgery - Tập 162 Số 4 - Trang 446-457 - 2020
Henrieke W. Schutte1,2, Floris Heutink1,2, David J. Wellenstein1, Guido B. van den Broek1, F.J.A. van den Hoogen1, Henri A. M. Marres1, Carla M.L. van Herpen3, J.H.A.M. Kaanders4, Matthias A.W. Merkx5, Robert P. Takes1
1Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
2these authors contributed equally to this work
3Department of Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
4Department of Radiation Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
5Department of Oral and Maxillofacial Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands

Tóm tắt

ObjectiveAn increased interval between symptomatic disease and treatment may negatively influence oncologic and/or functional outcomes in head and neck cancer (HNC). This systematic review aims to provide insight into the effects of time to treatment intervals on oncologic and functional outcomes in oral cavity, pharyngeal, and laryngeal cancer.Data SourcesPubMed, EMBASE, and Cochrane library were searched.Review MethodsAll studies on delay or time to diagnosis or treatment in oral, pharyngeal, and laryngeal cancer were included. Quality assessment was performed with an adjusted version of the Newcastle‐Ottawa scale. Outcomes of interest were tumor volume, stage, recurrence, survival, patient‐reported outcome measures (PROMs), toxicity, and functionality after treatment.ResultsA total of 51 studies were included. Current literature on the influence of delay in HNC is inconsistent but indicates higher stage and worse survival with longer delay. The effects on PROMs, toxicity, and functional outcome after treatment have not been investigated. The inconsistencies in outcomes were most likely caused by factors such as heterogeneity in study design, differences in the definitions of delay, bias of results, and incomplete adjustment for confounding factors in the included studies.ConclusionIrrespective of the level of evidence, the unfavorable effects of delay on oncologic, functional, and psychosocial outcomes are undisputed. Timely treatment while maintaining high‐quality diagnostic procedures and decision making reflects good clinical practice in our opinion. This review will pose practical and logistic challenges that will have to be overcome.

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Otolaryngology - Head and Neck Surgery

Tập 162 Số 4

446-457

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