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

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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The Impact of Smoking, Alcohol Use, Recurrent Disease, and Age on the Development of Neck Fibrosis in Head and Neck Cancer Patients Following Radiation Therapy

Frontiers in Oncology ◽

10.3389/fonc.2021.707418 ◽

2021 ◽

Vol 11 ◽

Author(s):

Connor L. Pratson ◽

Michael C. Larkins ◽

Brandon H. Karimian ◽

Caitrin M. Curtis ◽

Pamela A. Lepera ◽

...

Keyword(s):

Head And Neck Cancer ◽

Alcohol Use ◽

Head And Neck ◽

Neck Cancer ◽

Recurrent Disease ◽

Care Center ◽

Univariate Analysis ◽

Tertiary Care ◽

Factors Associated ◽

The Impact

There is a paucity of information regarding the demographic factors associated with the development of neck fibrosis in head and neck cancer (HNC) patients following radiotherapy. A retrospective review of all patients being treated for HNC at a tertiary care center between 2013 and 2017 was performed. Chi-squared and Mann-Whitney U tests were used to identify differences in incidence and grade of fibrosis, respectively, between populations. A total of 90 patients aged 19 to 99 years were included. Factors associated with an increased incidence of fibrosis included smoking during radiotherapy (p < 0.001), alcohol use (p = 0.026), recurrent disease (p = 0.042), and age less than 60 (p < 0.001) on univariate analysis. Factors associated with increased grade of fibrosis in HNC patients included recurrent HNC (p = 0.033), alcohol use (p = 0.013), patient age younger than 60 years (p = 0.018), smoking during radiotherapy (p < 0.001), and non-Caucasian race (p = 0.012). Identification and intervention directed at patients that possess risk factors associated with fibrosis prior to treatment has the potential to improve the long-term quality of life for HNC patients.

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

OTO Open ◽

10.1177/2473974x211059429 ◽

2021 ◽

Vol 5 (4) ◽

pp. 2473974X2110594

Author(s):

Peter Yao ◽

Victoria Cooley ◽

William Kuhel ◽

Andrew Tassler ◽

Victoria Banuchi ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Medical Center ◽

Academic Medical Center ◽

Head And Neck Cancers ◽

Newly Diagnosed ◽

Time To Treatment ◽

Time To Diagnosis ◽

The Times

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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Head and Neck Cancer—A Clinicopathological Study in a Tertiary Care Center

Journal of the National Medical Association ◽

10.1016/s0027-9684(15)31343-2 ◽

2008 ◽

Vol 100 (6) ◽

pp. 690-697 ◽

Cited By ~ 20

Author(s):

Bukola F Adeyemi ◽

Lola V Adekunle ◽

Bamidele M Kolude ◽

Effiong E.U. Akang ◽

Jonathan O. Lawoyin

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Care Center ◽

Tertiary Care ◽

Tertiary Care Center ◽

Clinicopathological Study

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Efficacy of Radiologic Screening for Distant Metastases and Second Primaries in Newly Diagnosed Patients With Head and Neck Cancer

The Laryngoscope ◽

10.1097/01.mlg.0000248232.27668.57 ◽

2007 ◽

Vol 117 (2) ◽

pp. 242-247 ◽

Cited By ~ 14

Author(s):

Martin C. J??ckel ◽

Andrea Reischl ◽

Peter Huppert

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Distant Metastases ◽

Newly Diagnosed ◽

Second Primaries

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P-40 Radiotherapy with curative intent in head and neck cancer – Experience from a tertiary care center

Oral Oncology ◽

10.1016/s1368-8375(21)00328-6 ◽

2021 ◽

Vol 118 ◽

pp. 2

Author(s):

André Laranja ◽

Diana Moreira ◽

Isabel Reis ◽

Isabel Rodrigues ◽

Fausto Sousa ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Care Center ◽

Tertiary Care ◽

Tertiary Care Center ◽

Curative Intent ◽

Cancer Experience

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Prognostic evaluation in head and neck cancer patients: a clinicoimaging tertiary care center study

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20213778 ◽

2021 ◽

Vol 8 (10) ◽

pp. 4831

Author(s):

N. Kavya Keerthika ◽

D. Sri Veda ◽

M. P. V. Prabhat ◽

G. Sarat ◽

Gunmeet Maini

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Care Center ◽

Tertiary Care ◽

World Health ◽

Treatment Modalities ◽

Prognostic Evaluation ◽

Etiological Factors

Background: The occurrence of the head and neck cancers (HNC) is increasing day by day. These have been associated with multiple etiological factors, and early diagnosis has a prime role in the patient's prognosis and overall survival. Prognostic evaluation in head and neck cancer patients utilizing clinical incidence and imaging outcomes.Methods: The study sample included 217 confirmed HNC patients’ data obtained from the tertiary cancer care centre were analysed to assess the prognosis and be subjected to statistical analysis.Results: Out of all HNC, cancer pertaining to the lip and oral cavity was the most common variety with 65.89% and most of the HNC occurred in men of about 97%, suggesting a strong association with adverse oral habits.Conclusions: We conclude that the current scenario of HNC’s progression and treatment modalities in Andhra Pradesh were in comparison to the World Health Organization (WHO) data suggests an increase in the awareness of the etiological factors and the disease progression. Though various advanced imaging and treatment modalities are available, the patients' prognosis is untethered due to low socio-economic status in this region.

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Perioperative Deep Vein Thrombosis Risk Stratification: A Comparative Analysis of Free and Pedicled Flap Patients

Otolaryngology ◽

10.1177/0194599816667399 ◽

2016 ◽

Vol 156 (1) ◽

pp. 118-121 ◽

Cited By ~ 4

Author(s):

Sumi Sinha ◽

Sidharth V. Puram ◽

Rosh K. V. Sethi ◽

Neerav Goyal ◽

Kevin S. Emerick ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Care Center ◽

Tertiary Care ◽

Pedicled Flap ◽

Vein Thrombosis ◽

Thrombosis Risk ◽

Reconstructive Operations ◽

Deep Vein

Patients with head and neck cancer who undergo reconstructive surgery are at risk for deep venous thrombosis (DVT), but the risk profile for patients undergoing major flap reconstruction is highly variable. Herein, we report our findings from a retrospective analysis of head and neck cancer patients (n = 517) who underwent free (n = 384) or pedicled (n = 133) flap reconstructive operations at a major tertiary care center from 2011 to 2014. DVTs developed perioperatively in 9 (1.7%) patients. Compared with pedicled flap patients, free flap patients had a longer mean operative time (421.4 ± 4.4 vs 332.7 ± 10.7 min, P < .0001), but the DVT incidence did not differ significantly between free and pedicled flap patients (1.6% vs 2.2%, respectively, P = .28). These data suggest that perioperative DVT risk in head and neck oncology patients may be largely similar regardless of the reconstructive strategy pursued.

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Oligometastatic head and neck cancer: Which patients benefit from radical local treatment of all tumour sites?

Radiation Oncology ◽

10.1186/s13014-021-01790-w ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Thomas Weissmann ◽

Daniel Höfler ◽

Markus Hecht ◽

Sabine Semrau ◽

Marlen Haderlein ◽

...

Keyword(s):

Overall Survival ◽

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Performance Status ◽

Local Treatment ◽

Distant Metastases ◽

Tumour Volume ◽

The Impact ◽

Total Tumour Volume

Abstract Background There is a large lack of evidence for optimal treatment in oligometastatic head and neck cancer and it is especially unclear which patients benefit from radical local treatment of all tumour sites. Methods 40 patients with newly diagnosed oligometastatic head and neck cancer received radical local treatment of all tumour sites from 14.02.2008 to 24.08.2018. Primary endpoint was overall survival. Time to occurrence of new distant metastases and local control were evaluated as secondary endpoints as well as prognostic factors in univariate und multivariate Cox’s regression analysis. To investigate the impact of total tumour volume on survival, all tumour sites were segmented on baseline imaging. Results Radical local treatment included radiotherapy in 90% of patients, surgery in 25% and radiofrequency ablation in 3%. Median overall survival from first diagnosis of oligometastatic disease was 23.0 months, 2-year survival was 48%, 3-year survival was 37%, 4-year survival was 24% and 5-year survival was 16%. Median time to occurrence of new distant metastases was 11.6 months with freedom from new metastases showing a tail pattern after 3 years of follow-up (22% at 3, 4- and 5-years post-treatment). In multivariate analysis, better ECOG status, absence of bone and brain metastases and lower total tumour volume were significantly associated with improved survival, whereas the number of metastases and involved organ sites was not. Conclusions Radical local treatment in oligometastatic head and neck cancer shows promising outcomes and needs to be further pursued. Patients with good performance status, absence of brain and bone metastases and low total tumour volume were identified as optimal candidates for radical local treatment in oligometastatic head and neck cancer and should be considered for selection in future prospective trials.

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