Times to Diagnosis, Staging, and Treatment of Head and Neck Cancer Before and During COVID-19

Objective The coronavirus disease 2019 (COVID-19) pandemic has reduced the demand for, and supply of, head and neck cancer services. This study compares the times to diagnosis, staging, and treatment of head and neck cancers before and during the COVID-19 pandemic. Study Design Retrospective cohort study. Setting Tertiary academic medical center in New York City (NYC). Methods The times to diagnosis, staging, and treatment of head and neck cancer for patients presenting to the clinics of 4 head and neck oncology surgeons with newly diagnosed head and neck cancers were compared between pre–COVID-19 and COVID-19 periods. Results Sixty-eight patients in the pre–COVID-19 period and 26 patients in the COVID-19 period presented with newly diagnosed head and neck cancer. Patients in the COVID-19 group had a significantly longer time to diagnosis than the pre–COVID-19 group after adjustment for age and cancer diagnosis ( P = .02; hazard ratio [HR], 0.54; 95% CI, 0.32-0.92). Patients in the pre–COVID-19 and COVID-19 groups had no statistically significant differences in time to staging ( P > .9; HR, 1.01; 95% CI, 0.58-1.74) or time to treatment ( P = .12; HR, 1.55; 95% CI, 0.89-2.72). Conclusion This study found that time to diagnosis for head and neck cancers was delayed during a COVID-19 period compared to a pre–COVID-19 period. However, there was no evidence of delays in time to staging and time to treatment during the COVID-19 period. Our results prompt further investigations into the factors contributing to diagnostic delays but provide reassurance that despite COVID-19, patients were receiving timely staging and treatment for head and neck cancers.

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Evaluation of tumor oxygenation by color duplex sonography: A new approach

Otolaryngology ◽

10.1016/j.otohns.2005.01.033 ◽

2005 ◽

Vol 132 (5) ◽

pp. 765-769 ◽

Cited By ~ 8

Author(s):

Ercole F.N. Di Martino ◽

Bernd Gagel ◽

Oliver Schramm ◽

Payam Maneschi ◽

Martin Westhofen

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Medical Center ◽

Academic Medical Center ◽

Duplex Sonography ◽

Tumor Oxygenation ◽

Controlled Study ◽

Color Duplex Sonography ◽

New Approach

OBJECTIVE: Description of a new noninvasive method for the evaluation of tissue oxygenation in head and neck cancer. STUDY DESIGN AND SETTING: Prospective nonrandomized controlled study in an academic medical center on 20 patients with neck metastases of head and neck cancer. Metastases were investigated using color duplex sonography and pO2 histography. The vascularization in sonography was quantitatively evaluated by color pixel density and compared to the pO2 values of the same nodes. RESULTS: The correlation between vascularization and flow velocity was 0.71. For the mean/median pO2-values and for the pO2 readings < 10.0 mmHg correlations were r = 0.65/0.76 and 0.71. CONCLUSION: This sonographic method allows a safe and reliable evaluation of oxygenation in metastases of head and neck cancer. SIGNIFICANCE: The new approach is an alternative to pO2 histography and may play a future role in the planning of radiotherapy in the neck. (Otolaryngol Head Neck Surg 2005;132:765-9.)

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Evaluation of the head and neck cancer patient population and the incidence of hospitalization at an academic medical center

Journal of Oncology Pharmacy Practice ◽

10.1177/1078155217735688 ◽

2017 ◽

Vol 25 (2) ◽

pp. 333-338 ◽

Cited By ~ 4

Author(s):

Lindsay A Hazelden ◽

Matthew J Newman ◽

Stephanie Shuey ◽

Julie M Waldfogel ◽

Victoria T Brown

Keyword(s):

Logistic Regression ◽

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Medical Center ◽

Academic Medical Center ◽

Factors Associated ◽

Chemotherapy Agent ◽

Academic Medical ◽

The Impact

Purpose Patients with head and neck cancer are at risk for disease- and treatment-related toxicities that may be severe enough to require hospitalization. The risk factors associated with hospitalization in these patients are not well defined. Methods We conducted a single-center, retrospective observational study of patients with head and neck cancer receiving chemotherapy at an academic medical center infusion clinic in a one-year period. The primary objective was to characterize the head and neck cancer population at an academic medical center. Secondary objectives included describing the clinical and social factors associated with hospitalization. Results There were 109 patients with head and neck cancer included in the analysis. Of these patients, 38 (35%) were hospitalized. The factors that were significantly associated with hospitalization on univariable logistic regression were former alcohol abuse, being on a nonstandard of care chemotherapy regimen, and having a chemotherapy agent discontinued. On multivariable logistic regression, the factor that was significantly associated with hospitalization was having a chemotherapy agent discontinued. The most common reasons for hospitalization included shortness of breath/respiratory failure, fever/neutropenic fever, and infection. The most common new supportive care medications prescribed at discharge were stool softeners or laxatives and opioids. Conclusion This study identified several factors which may be useful to identify patients as high risk for hospitalization and the next steps will be to determine and study the role of the pharmacist in preventing hospitalization of these patients. Further studies are needed to assess the impact of adding a pharmacist to the head and neck cancer multidisciplinary team.

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The Impact of COVID-19 on Head and Neck Cancer Treatment: Before and During the Pandemic

OTO Open ◽

10.1177/2473974x211068075 ◽

2021 ◽

Vol 5 (4) ◽

pp. 2473974X2110680

Author(s):

Roberto N. Solis ◽

Mehrnaz Mehrzad ◽

Samya Faiq ◽

Roberto P. Frusciante ◽

Harveen K. Sekhon ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Care Center ◽

Tertiary Care ◽

Distant Metastases ◽

Newly Diagnosed ◽

Duration Of Symptoms ◽

Time To Diagnosis ◽

The Impact

Objectives To describe the impact that the coronavirus disease 2019 (COVID-19) pandemic had on the presentation of patients with head and neck cancer in a single tertiary care center. Study Design Retrospective cohort study. Setting Academic institution. Methods We performed a retrospective review of patients with newly diagnosed head and neck squamous cell carcinoma (HNSCC) who presented as new patients between September 10, 2019, and September 11, 2020. Patients presenting during the 6 months leading up to the announcement of the pandemic (pre–COVID-19 period) on March 11, 2020, were compared to those presenting during the first 6 months of the pandemic (COVID-19 period). Demographics, time to diagnosis and treatment, and tumor characteristics were analyzed. Results There were a total of 137 patients analyzed with newly diagnosed malignancies. There were 22% fewer patients evaluated during the COVID-19 timeframe. The groups were similar in demographics, duration of symptoms, time to diagnosis, time to surgery, extent of surgery, and adjuvant therapy. There was a larger proportion of tumors classified as T3/T4 (61.7%) in the COVID-19 period vs the pre–COVID-19 period (40.3%) ( P = .024), as well as a larger median tumor size during the COVID-19 period ( P = .0002). There were no differences between nodal disease burden ( P = .48) and distant metastases ( P = .42). Conclusion Despite similar characteristics, time to diagnosis, and surgery, our findings suggest that there was an increase in primary tumor burden in patients with HNSCC during the early COVID-19 pandemic.

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Follow-Up Phone Interviews and Attendance Motivation From A Free Head and Neck Cancer Screening

Ear Nose & Throat Journal ◽

10.1177/0145561320940866 ◽

2020 ◽

pp. 014556132094086

Author(s):

Zachary D. Urdang ◽

David H. Rosales ◽

QiLiang Chen ◽

Ryan J. Li ◽

Peter E. Andersen ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Medical Center ◽

Academic Medical Center ◽

Significant Proportion ◽

Community Outreach ◽

Cancer Center ◽

Screening Programs

Introduction: Head and Neck Cancer Awareness and Screening Programs (HNCASP) are popular community outreach events hosted by academic and community otolaryngology departments. However, long-term follow-up of participants is lacking. Patients and Methods: Participants of a HNCASP held at an academic cancer center prospectively filled out demographic and risk factor surveys followed by HNC screening examination. A phone interview was conducted for participants between 2012 and 2016 with suspicious findings to assess outcomes. Results: Participants were largely Caucasian, female, and had health insurance, reflecting the setting at an academic medical center. Despite this, there were 156 (16.8%) positive screenings; 47 of these completed follow up interviews. Twelve (1.1% of all participants) cancer cases were confirmed. Discussion: A significant proportion of HNCASP participants benefited from this screening opportunity. Education regarding HNC is the primary benefit and motivational factor for attendance of HNCASPs, although a significant subset of patients was identified that needed follow-up, and several cancers were detected.

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Long Term Outcome of Routine Image-enhanced Endoscopy in Newly Diagnosed Head and Neck Cancer: a Prospective Study of 145 Patients

Scientific Reports ◽

10.1038/srep29573 ◽

2016 ◽

Vol 6 (1) ◽

Cited By ~ 3

Author(s):

Chen-Shuan Chung ◽

Wu-Chia Lo ◽

Ming-Hsun Wen ◽

Chen-Hsi Hsieh ◽

Yu-Chin Lin ◽

...

Keyword(s):

Head And Neck Cancer ◽

Prospective Study ◽

Head And Neck ◽

Neck Cancer ◽

Newly Diagnosed ◽

Term Outcome ◽

Long Term Outcome ◽

A Prospective Study

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Does Quitting Smoking Make a Difference Among Newly Diagnosed Head and Neck Cancer Patients?

Nicotine & Tobacco Research ◽

10.1093/ntr/ntw189 ◽

2016 ◽

Vol 18 (12) ◽

pp. 2216-2224 ◽

Cited By ~ 18

Author(s):

Seung Hee Choi ◽

Jeffrey E. Terrell ◽

Carol R. Bradford ◽

Tamer Ghanem ◽

Matthew E. Spector ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Newly Diagnosed ◽

Quitting Smoking

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Perioperative mortality of head and neck cancers

BMC Cancer ◽

10.1186/s12885-021-07998-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yannan Wang ◽

Mengxue Wang ◽

Yan Tang ◽

Bincan Sun ◽

Kai Wang ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Cardiopulmonary Arrest ◽

Clinical Stage ◽

Maxillofacial Surgery ◽

Head And Neck Cancers ◽

Oral And Maxillofacial Surgery ◽

Perioperative Mortality ◽

Advanced Clinical Stage

Abstract Background Head and neck cancers are aggressive cancers, most clinical studies focused on the prognosis of patients with head and neck cancer. However, perioperative mortality was rarely mentioned. Methods A retrospective analysis was performed using all head and neck cancer patients admitting in the Department of Oral and Maxillofacial Surgery of the Second Xiangya Hospital, Central South University from January 2010 to December 2019. The analysis of overall survival and progression-free survival were performed using the Kaplan–Meier method, and cross tabulation with chi-squared testing was applied to analyze the difference in parameters between groups. Results From January 2010 to December 2019, a total of 6576 patients with head and neck cancers were admitted to our department and 7 died in the hospital, all of whom were middle-aged and elderly patients including 6 males and 1 female. The perioperative mortality rate (POMR) was about 1‰. The causes of death included acute heart failure, rupture of large blood vessels in the neck, hypoxic ischemic encephalopathy due to asphyxia, respiratory failure and cardiopulmonary arrest. Conclusion Preoperative radiotherapy, previous chemotherapy, hypertension, diabetes, advanced clinical stage and postoperative infection are risk factors for perioperative mortality of head and neck cancer.

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Update and external validation of a multivariable prediction model for tube feeding dependency for at least four weeks during chemoradiotherapy for head and neck cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.6040 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 6040-6040

Author(s):

Anna C. H. Willemsen ◽

Annemieke Kok ◽

Laura W.J. Baijens ◽

J. P. De Boer ◽

Remco de Bree ◽

...

Keyword(s):

Head And Neck Cancer ◽

Radiation Dose ◽

The Netherlands ◽

Prediction Model ◽

Head And Neck ◽

Neck Cancer ◽

Predictive Value ◽

Medical Center ◽

External Validation ◽

Tube Feeding

6040 Background: Patients who receive chemoradiation or bioradiation (CRT/BRT) for locally advanced head and neck squamous cell carcinoma (LAHNSCC) often experience high toxicity rates, which may interfere with oral intake, leading to (temporary) tube feeding (TF) dependency. International guidelines recommend gastrostomy insertion when the expected use of TF exceeds four weeks. In this study we aimed to update and externally validate a prediction model to identify patients in need for TF for at least four weeks, meeting the international criteria for prophylactic gastrostomy insertion. Methods: This retrospective multicenter cohort study was performed in four tertiary referral head and neck cancer centers in the Netherlands. The prediction model was developed using data from the University Medical Center Utrecht and the Netherlands Cancer Institute. The model was externally validated in patients from the Maastricht University Medical Center and Radboud University Medical Center. The primary endpoint was TF, initiated during or within 30 days after completion of CRT/BRT, and administered for at least four weeks. Potential predictors were retrieved from patient medical records and radiotherapy dose-volume parameters were calculated. Results: The developmental and validation cohort included 409 and 334 patients respectively. Multivariable analysis showed significant predictive value (p < 0.05) for adjusted diet at start of CRT/BRT, percentage weight change prior to treatment initiation, WHO performance status, tumor-site, nodal stage, mean radiation dose to the contralateral parotid gland, and mean radiation dose to the oral cavity. The area under the receiver operating characteristics curve for the updated model was 0.73 and after external validation 0.64. Positive and negative predictive value at 90% cut off were 80.0% and 48.2% respectively. Conclusions: This externally validated prediction model to estimate TF-dependency for at least four weeks in LAHNSCC patients performs well. This model, which will be presented, can be used in clinical practice to guide personalized decision making on prophylactic gastrostomy insertion.

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Postoperative Radiotherapy in Head and Neck Cancer

Otorhinolaryngology Clinics - An International Journal ◽

10.5005/jp-journals-10003-1016 ◽

2010 ◽

Vol 2 (1) ◽

pp. 43-51

Author(s):

Vedang Murthy ◽

Sayan Kundu ◽

Tanweer Shahid ◽

Ashwini Budrukkar ◽

Tejpal Gupta ◽

...

Keyword(s):

Head And Neck Cancer ◽

Targeted Therapy ◽

Head And Neck ◽

Neck Cancer ◽

Early Stage ◽

Postoperative Radiotherapy ◽

Locally Advanced ◽

Head And Neck Cancers ◽

Advanced Head ◽

Locoregional Failure

Abstract Though early stage head and neck cancers can be cured either by surgery or radiation, patients with locally advanced disease continues to pose a therapeutic challenge. Locoregional failure is the major cause of death in head and neck cancers. As the outcome of locally advanced head and neck cancer is less than promising, a combined modality approach is generally undertaken in this group of patients. The combination of surgery, radiation and more recently, chemotherapy and targeted therapy can improve outcomes in locally advanced head and neck cancer patients. This overview discusses the rationale and role of postoperative radiotherapy (PORT) in advanced head and neck cancers, the radiotherapy technique in brief and methods of enhancing the efficacy of postoperative RT by altering the fractionation schedules and adding chemotherapy and targeted therapy.

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Filipino head and neck cancer patients and their quality of life

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20200540 ◽

2020 ◽

Vol 6 (3) ◽

pp. 439

Author(s):

Frederic Ivan L. Ting ◽

Aylmer Rex B. Hernandez ◽

Reno Eufemon P. Cereno ◽

Irisyl B. Orolfo-Real ◽

Corazon A. Ngelangel

Keyword(s):

Quality Of Life ◽

Head And Neck Cancer ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

The Philippines ◽

Head And Neck Cancers ◽

The Social ◽

The University

Background: In the management of head and neck cancer (HNC), assessment of quality of life (QoL) is imperative because of the potentially debilitating effect of treatment toxicities. Currently, there are no published data assessing the QoL in Filipino HNC patients, thus this study.Methods: This cross-sectional study utilized the University of the Philippines - Department of Health Quality of Life scale. Patients with head and neck cancers at the University of the Philippines - Philippine General Hospital from February to September 2019 were invited to participate. Results: A total of 418 patients were included in the study with a mean age of 42 years old (range 18 to 73 years old). In general, Filipino head and neck cancer patients had moderate QoL (mean score of 4.59±0.79). All of the QoL domains (physical, emotional, cognitive, and related functions) had a score of 3-5 (moderate), except for the social status domain which had a mean score of 5.51±0.83 (high). Among socio-demographic factors, patients who are employed and with additional funding sources on top of their income have better global QoL (p<0.01). Clinically, patients with higher stages of disease, fungating tumors, post-laryngectomy, have a feeding tube, with a tracheostomy, and had chemotherapy have lower global QoL (p<0.01).Conclusions: Filipino patients with head and neck cancers have an overall moderate quality of life, with high scores in the social domain. Patients with higher tumor burdens and have been exposed to chemotherapy have lower QoL scores, while patients with financial stability and aid have better QoL scores.

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