HealthDay News — For patients with head and neck squamous cell carcinoma, time to treatment initiation (TTI) impacts overall survival, according to a study published in the Journal of Clinical Oncology.

Colin T. Murphy, MD, from the Fox Chase Cancer Center in Philadelphia, and colleagues used the National Cancer Data Base to examine 51,655 patients who received curative therapy for cancers of the oral tongue, oropharynx, larynx, and hypopharynx. The authors examined the impact of TTI on overall survival using Cox regression models (multivariate analysis [MVA]).

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The researchers found that TTI of 61 to 90 versus less than 30 days correlated with increased mortality risk, on MVA (hazard ratio, 1.13). On the training recursive partitioning analysis, TTI of 67 days was the optimal threshold; statistical significance was confirmed in the validation set. In 54% of repeated simulations the 67-day TTI was the optimal threshold. Two optimal TTI thresholds were validated in 96%t of simulations, with ranges of 46 to 52 days and 62 to 67 days. The median overall survival was 71.9 months for TTI of 46 to 52 days or fewer; 61 months for 53 to 67 days; and 46.6 months for greater than 67 days (P < 0.001).

“This study demonstrated that patients with TTI of greater than 46 to 52 days have increased risk of mortality that is greatest for patients with early-stage disease,” the authors write.


Murphy C, Galloway T, Handorf E et al. Survival Impact of Increasing Time to Treatment Initiation for Patients With Head and Neck Cancer in the United States. ‎J. Clin. Oncol. 2015. doi:10.1200/jco.2015.61.5906.