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Scientific Oral Presentations

Head and Neck Surgery

Session: Scientific Oral Presentations 6 - Head and Neck Surgery

Differences in Adjuvant Radiotherapy Delay Between Oral Cavity and Oropharyngeal Cancer: A Cohort Study

Monday, September 30, 2024
3:12 PM – 3:18 PM EDT
Location: MBCC, 208
Disclosure(s):
Jake J. Lee, MD, MSCI:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Anusha G. Naik, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Karthik Rajasekaran, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Ara A. Chalian, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Steven B. Cannady, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

D Gregory Farwell, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Christopher H. Rassekh, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Devraj Basu, MD, PhD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Ryan M. Carey, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

John N. Lukens, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Robert M. Brody, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: The adverse impact of adjuvant treatment delays, defined as <6 weeks between oncologic surgery and radiotherapy (RT) initiation, has been shown, but risk factors have not been compared between oral cavity (OCSCC) and oropharyngeal squamous cell carcinoma (OPSCC) patients.

Methods: A single-center retrospective cohort study of consecutive patients with OCSCC and OPSCC who underwent surgical resection and adjuvant RT from July 1, 2011 to January 31, 2019 was conducted. Patients with prior head and neck cancer, prior RT, and palliative intent were excluded. The primary outcome was the interval between surgery and adjuvant RT initiation.

Results: In total, 639 patients (mean age 60.4 [10.1] years, 130 [20%] females) were included, of whom 195 (31%) had OCSCC and 444 (69%) had OPSCC. The median intervals between surgery and adjuvant RT initiation in the OCSCC and OPSCC cohorts were 63.0 (IQR 49-82) and 59.5 (IQR 52-69) days, respectively. Adjuvant RT delay was significantly associated with OPSCC pathology (aRR 1.08, 95% CI 1.01-1.15), smoking history (aRR 1.09, 95% CI 1.03-1.15), free flap reconstruction (aRR 1.07, 95% CI 1.01-1.13), and increased length of stay on multivariable analysis. Treatment delay was not significantly associated with age, sex, race, comorbidity burden, insurance status, stage, surgical take-back, gastrostomy tube, concurrent chemotherapy, or radiation facility.

Conclusions: OPSCC patients had an 8% increased risk of adjuvant RT delay compared to OCSCC patients. Smoking history, free flap reconstruction, and longer index hospitalizations were also associated with adjuvant RT delay. While prognoses are generally more favorable in OPSCC patients, it is still imperative to streamline multidisciplinary care for these patients and promote timely care.

    Presenting Author(s)

  • Jake J. Lee, MD, MSCI

    Assistant Professor
    Stanford University
    Closter, NJ, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • Anusha G. Naik, BS

    Medical Student
    Department of Otorhinolaryngology Head and Neck Surgery, Hospital of the University of Pennsylvania
    Philadelphia, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Karthik Rajasekaran, MD

    Associate Professor, Head and Neck Oncologic & Reconstructive Surgeon, Director of QI
    Department of Otorhinolaryngology Head and Neck Surgery, Hospital of the University of Pennsylvania
    Philadelphia, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • GW

    Gregory S. Weinstein, MD

    Director, Head and Neck Cancer Service Line
    Department of Otorhinolaryngology Head and Neck Surgery, Hospital of the University of Pennsylvania
    Philadelphia , PA, United States

    Disclosure information not submitted.

  • AC

    Ara A. Chalian, MD

    Professor
    Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA
    Philadelphia, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • SC

    Steven B. Cannady, MD

    Associate Professor
    Department of Otorhinolaryngology Head and Neck Surgery, Hospital of the University of Pennsylvania
    Philadelphia, Pennsylvania, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • D Gregory Farwell, MD

    Professor and Chair
    University of Pennsylvania School of Medicine
    Philadelphia, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Christopher H. Rassekh, MD

    Professor
    University of Pennsylvania
    Philadelphia, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Devraj Basu, MD, PhD

    Associate Professor
    University of Pennsylvania
    Philadelphia, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • RC

    Ryan M. Carey, MD

    Assistant Professor
    Department of Otorhinolaryngology Head and Neck Surgery, Hospital of the University of Pennsylvania
    Philadelphia, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • JL

    John N. Lukens, MD

    Assistant Professor
    Department of Radiation Oncology, Hospital of the University of Pennsylvania
    Philadelphia, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • MG

    Michelle S. Gentile, MD

    Assistant Professor
    Department of Radiation Oncology, Hospital of the University of Pennsylvania
    Philadelphia, Pennsylvania, United States

    Disclosure information not submitted.

  • AL

    Alexander Lin, MD

    Professor
    Department of Radiation Oncology, Hospital of the University of Pennsylvania
    Philadelphia, Pennsylvania, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • Robert M. Brody, MD

    Assistant Professor
    Department of Otorhinolaryngology Head and Neck Surgery, Hospital of the University of Pennsylvania
    Philadelphia, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.