Quantitative Survival Impact of Composite Treatment Delays in Head and Neck Cancer
Quantitative Survival Impact of Composite Treatment Delays in Head and Neck Cancer
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DOI：
10.1002/cncr.31533
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发表时间：
2018-08-01
期刊：
影响因子：
6.2
通讯作者：
Zumsteg, Zachary S.
中科院分区：
文献类型：
--
作者：
Ho, Allen S.;Kim, Sungjin;Zumsteg, Zachary S.
背景技术背景：头颈部癌症（HNC）的多学科管理必须协调日益复杂的专科护理与及时护理。先前的研究检查了诊断至治疗间隔、术后间隔和放疗间隔延迟的个体效应，但没有将其作为整体考虑。本研究的目的是研究这些交织间期对HNC患者的综合影响。方法：在2004年至2013年期间，在国家癌症数据库中确定了接受放射治疗手术的HNC患者。使用限制性三次样条构建多变量模型，以确定与总生存期的非线性关系。结果：总共有15，064名患者接受了评估。调整协变量后，仅术后间隔时间延长（P
BACKGROUND: Multidisciplinary management of head and neck cancer (HNC) must reconcile increasingly sophisticated subspecialty care with timeliness of care. Prior studies examined the individual effects of delays in diagnosis-to-treatment interval, postoperative interval, and radiation interval but did not consider them collectively. The objective of the current study was to investigate the combined impact of these interwoven intervals on patients with HNC. METHODS: Patients with HNC who underwent curative-intent surgery with radiation were identified in the National Cancer Database between 2004 and 2013. Multivariable models were constructed using restricted cubic splines to determine nonlinear relations with overall survival. RESULTS: Overall, 15,064 patients were evaluated. After adjustment for covariates, only prolonged postoperative interval (P