Evaluation of Patient Outcome Benefits and Resource Utilization Associated with a Hematopathologist-Directed Workflow for Diagnosis of Hematological Malignancies

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 3127-3127
Author(s):  
John F Leite ◽  
Sudipto Sur ◽  
Bashar Dabbas ◽  
James Gilmore ◽  
Sally Haislip ◽  
...  
Keyword(s):  
Overall Survival ◽  
Patient Outcomes ◽  
Resource Utilization ◽  
Analytical Framework ◽  
National Study ◽  
Regional Study ◽  
Cancer Specialists ◽  
One Year ◽  
The Impact ◽  
Selection Of

Abstract Abstract 3127 Background: Traditionally, the appropriate selection of diagnostic tests is determined solely by the ordering clinician. This can be quite challenging in the case of hematological malignancies, where guidelines require detailed correlation between molecular, morphologic and immunologic results for accurate classification. We have undertaken a study to determine the impact of including a hematopathologist in the initial test selection and case management. Our working hypothesis is that this should improve the timeliness and accuracy of diagnoses. Therefore, an analytical framework based on measuring patient outcomes and resource utilization is feasible to compare diagnostic workflows. We compared outcomes and resource utilization between cohorts of patients in which diagnosis was obtained using the traditional or hematopathologist supplemented workflows. Two studies were performed: the first utilized a smaller regional electronic health record (EHR) database from a Southeast US practice, affording a higher degree of practice and demographics uniformity, the second utilized a more heterogeneous national US claims database. Patients were matched by ultimate diagnosis and demographics and all studies were retrospective. Methods: In the first regional cohort, we studied 791 patients collected between 2007 and 2009 and required a minimum of one year of data post bone marrow biopsy to be available. The patients had a diagnostic evaluation by a hematopathologist-managed workflow (Test, n=640) or by laboratories that follow a traditional diagnostic workflow (Control, n=151). Patients were matched by gender, age, ethnicity, ECOG status and diagnosis. Outcomes were assessed as overall survival and transfusion dependence. Resource utilization (lab tests and supportive therapeutics) was also evaluated. As a sensitivity analysis, outcomes of 19, 416 patients from the national cohort were evaluated using patients collected between 2006 and 2008. These patients had a diagnostic evaluation by a hematopathologist-managed workflow (Test, n=3, 236) or by laboratories that follow a traditional diagnostic workflow (Control, n=16, 180). Patients were matched by gender, age, ethnicity, geography, payer type, Charlson co-morbidities and diagnosis. Results: Overall survival benefit for the regional EHR-based study was not observed beyond statistical significance (p=0.564, HR=0.530; 95%CI=0.233–1.205) although a strong trend favoring the Test cohort could be observed. In the national study, where claims data over one year was available for a greater proportion of patients, improved overall survival (p=0.050, HR=0.634; 95%CI=0.402–1.001) for Test cohort patients could be discerned. Test cohort patients exhibited improved transfusion dependence (p=0.009; HR=0.455, 95% CI=0.252–0.824) in the regional study, but this effect was not observed in the national study set (p=0.644; HR=0.959, 95% CI=0.803–1.145). Resource utilization was assessed in the regional study and Test cohort patients appear associated with significantly reduced resource utilization: lab tests (p<0.0001), ancillary procedures (p<0.0001), therapeutics (p<0.0001) and erythropoietin stimulating agents (p<0.0001). Conclusions: We present an analytical framework by which the impact on patient outcomes can be evaluated as a function of adding a hematopathologist in the selection of diagnostic tests and case management. Our initial results using EHR records from a multi-site single practice, and claims data from a national database, suggest that differences in outcomes and resource utilization can be discerned as a function of diagnostic workflow. Though we have done our best to reduce the possibility of distortion by confounding variables and unidentified bias, we hope that this study will provide the impetus for further replication across multiple cohorts, labs and prospective trials in the future. Disclosures: Leite: Genoptix-Novartis: Employment. Sur:Genoptix-Novartis: Consultancy. Dabbas:Genoptix-Novartis: Employment. Gilmore:Georgia Cancer Specialists: Employment. Haislip:Georgia Cancer Specialists: Employment. Nerenberg:Genoptix-Novartis: Employment.

Cost of Dementia and Its Correlation With Dependence

2016 ◽  
Vol 28 (8) ◽  
pp. 1448-1464 ◽  
Author(s):  
Örjan Åkerborg ◽  
Andrea Lang ◽  
Anders Wimo ◽  
Anders Sköldunger ◽  
Laura Fratiglioni ◽  
...  
Keyword(s):  
Cognitive Ability ◽  
Resource Utilization ◽  
Annual Cost ◽  
Neuropsychiatric Symptoms ◽  
Dementia Care ◽  
Cost Of Care ◽  
Path Model ◽  
National Study ◽  
Strong Impact ◽  
The Impact

Objective: To estimate the cost of dementia care and its relation to dependence. Method: Disease severity and health care resource utilization was retrieved from the Swedish National Study on Aging and Care. Informal care was assessed with the Resource Utilization in Dementia instrument. A path model investigates the relationship between annual cost of care and dependence, cognitive ability, functioning, neuropsychiatric symptoms, and comorbidities. Results: Average annual cost among patients diagnosed with dementia was €43,259, primarily incurred by accommodation. Resource use, that is, institutional care, community care, and accommodation, and corresponding costs increased significantly by increasing dependency. Path analysis showed that cognitive ability, functioning, and neuropsychiatric symptoms were significantly correlated with dependence, which in turn had a strong impact on annual cost. Discussion: This study confirms that cost of dementia care increases with dependence and that the impact of other disease indicators is mainly mediated by dependence.

scholarly journals DISTORSI KAPASITAS PERDAGANGAN INTER-REGIONAL IMT-GT Kasus Provinsi Terpilih di Sumatera Indonesia

2015 ◽  
Vol 11 (1) ◽  
pp. 44
Author(s):  
Benito Rio Avianto ◽  
Raldi Hendro Koestoer
Keyword(s):  
Analytical Framework ◽  
Economic Cooperation ◽  
Fixed Effect ◽  
Data Series ◽  
Regional Study ◽  
Regional Economic ◽  
Trade Sector ◽  
The Impact ◽  
Effect Method

The objective of the paper was to understand the impact of sub regional economic cooperation, known as the Indonesia-Malaysia-Thailand Growth Triangle (IMT-GT), on trade sector in Indonesia. The approach of research based on export macro information by provinces and commodities. The method used in the analytical framework was a fixed effect method. The regional study covered Nanggroe Aceh Darussalam, North Sumatera, West Sumatera, and Riau provinces, and the commodities involved CPO, coffee and rubber, with 1990-2008 data series. Based on pooled regression, there was a significant impact on export from the four provinces to Malaysia and Thailand for all based years. One might focus on commodity level that, in fact, CPO was the only one commodity that had a significant impact within the IMTGT region. In addition, Thai Bath and Malaysian Ringgit, with respect to GDP for both countries, had significant influenced on export, especially after the IMT-GT endorsed.

One-year mirror-image study of the impact of olanzapine long-acting injection on healthcare resource utilization and costs in severe schizophrenia

2018 ◽  
Vol 270 ◽  
pp. 205-210 ◽  
Author(s):  
Mylène Fefeu ◽  
Pierre De Maricourt ◽  
Arnaud Cachia ◽  
Nicolas Hoertel ◽  
Marie-Noëlle Vacheron ◽  
...  
Keyword(s):  
Resource Utilization ◽  
Healthcare Resource ◽  
Healthcare Resource Utilization ◽  
Mirror Image ◽  
Image Study ◽  
One Year ◽  
Long Acting ◽  
The Impact

Incidence and characterization of venous thromboembolic events (VTE) in patients with pancreatic cancer: Effect of timing of VTE on survival.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 4037-4037
Author(s):  
Maithili A Shethia ◽  
Aparna Hegde ◽  
Xiao Zhou ◽  
Michael J. Overman ◽  
Saroj Vadhan-Raj
Keyword(s):  
Pancreatic Cancer ◽  
Overall Survival ◽  
Survival Analysis ◽  
Kaplan Meier ◽  
Hazard Ratios ◽  
Venous Thromboembolic Events ◽  
Venous Thromboembolic ◽  
One Year ◽  
The Impact

4037 Background: Patients (pts) with pancreatic cancer are at high risk for VTE, and the occurrence of VTE can affect pts’ prognosis. The purpose of this study was to evaluate the incidence of VTE and the impact of timing of VTE (early vs. late) on survival. Methods: Medical record of 260 pts with pancreatic cancer, newly referred to UT MDACC during one year period from 1/1/2006 to 12/31/2006, were reviewed for the incidence of VTE during a 2-year follow-up period from the date of diagnosis. All VTE episodes were confirmed by radiologic studies. Survival analysis was conducted using Kaplan-Meier analysis and Cox proportional hazard models. Results: Of the 260 pts, 47 pts (18%) had 51 episodes of VTE during the 2-year follow-up. The median age of the pts with VTE was 61 years (range: 28-86) and 53% were males. Of the 47 pts with VTE, 27 (57%) had PE, 19 (40%) had DVT and 1 had concurrent PE/DVT. Three pts had recurrent VTE during the study period. Median follow-up time for OS was 192 days (range: 1-1652 days). Kaplan-Meier Survival analysis showed that those who developed VTE earlier (within 30 or 90 days) had shorter median overall survival (OS) compared with those who had VTE beyond these time points. The hazard ratios, 95% CI, and median OS at 1 year are summarized in the table below. Conclusions: The incidence of VTE is high in pts with pancreatic cancer. The timing of VTE had a significant impact on OS; pts who had an early development of VTE had a shorter overall survival. [Table: see text]

scholarly journals The Impact of Tobacco Smoking on One Year Patient Outcomes at a Family Medicine Residency Clinic

2016 ◽  
Vol 2 (3) ◽  
Author(s):  
Scott A. Fields ◽  
◽  
Satyakant Chitturi ◽  
Anoop Kumar ◽  
Jennifer Rose ◽  
...  
Keyword(s):  
Family Medicine ◽  
Patient Outcomes ◽  
Tobacco Smoking ◽  
Family Medicine Residency ◽  
One Year ◽  
The Impact

scholarly journals Simulation experiments of supply chain in a period of small and big disasters

2021 ◽  
Vol 43 ◽  
pp. 339-356
Author(s):  
Marcin Halicki ◽  
◽  
Tadeusz Kwater ◽  
Keyword(s):  
Supply Chain ◽  
Random Number Generator ◽  
Scientific Research ◽  
Graphical Analysis ◽  
Jel Classification ◽  
Anal Ysis ◽  
Value Contribution ◽  
One Year ◽  
The Impact ◽  
Selection Of

Aim/purpose – The aim of this paper is to present a strategy that allows companies to recover from disasters, when creating a supply chain. Furthermore, it also shows the impact on the company’s resources that are used in the implementation of the strategy in case of small and big disasters. Thanks to the proposed solution, it is possible to analyze each company individually, as well as in groups, at any given time. Design/methodology/approach – The results were obtained based on a numerical anal- ysis which was performed with the use of MATLAB software. The tests were carried out separately for five companies, as each of them may expect a disaster on any different day. However, the selection of the day when crises occur is carried out in accordance with the probability determined by scientific research. Findings – The research showed that companies using their resources can continue to fulfill their functions as a link in the Supply Chain despite the fact that they react differ- ently to small disasters compared to big ones. This difference occurs since small disas- ters in contrast to big ones appear in every company much more often. Consequently, it is more difficult for companies to build their wealth in the case of small disasters. The advantage of the proposed approach is that one can freely test which strategy can cause the least losses for the company as well as for the entire supply chain. Research implications/limitations – The analysis carried out shows that companies wishing to develop in conditions of unexpected disasters, that cannot be predicted, should regularly increase their assets because they are needed to implement a strategy that allows them to maintain an appropriate operational level. This approach provides tools that enable the selection of strategies with variable parameters, freely determined during the scientific research. Originality/value/contribution – The paper presents a graphical analysis of the change in the value of resources of a supply chain company over one year period. Such an anal- ysis may be useful for any company that creates a supply chain during the COVID-19 crisis period, which is an unpredictable disaster. The adoption of a Gaussian Pseudo Random Number Generator turned out to be useful as it creates crises days while simula- tion studies allow us to generate experiments for different data configurations. This pa- per provides an analysis of small and large disasters separately, which is an approach not presented in the literature. Keywords: supply chain, disaster, strategy, threats, simulations. JEL Classification: M21, D81, D84, C44

The incidence and impact of comorbidity on survival and selection of initial treatment in elderly patients (pts) with head and neck cancer (HNC)

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 6065-6065
Author(s):  
A. Ghobadi ◽  
M. Athar ◽  
J. Dowell
Keyword(s):  
Overall Survival ◽  
Initial Treatment ◽  
Clinical Stage ◽  
Primary Site ◽  
Unknown Primary ◽  
Curative Intent ◽  
Advanced Clinical Stage ◽  
Comorbidity Index ◽  
The Impact ◽  
Selection Of

6065 Background: Comorbidity has been shown to be a determinant of survival and treatment selection in various cancers including HNC. Higher comorbidity index is associated with higher utilization of non-curative intent treatment. Methods: In this retrospective study we analyzed 182 consecutively treated HNC pts >65 years (y) old at the Dallas VAMC from January 2000 through June 2007. Comorbidity was assessed with the Charlson Comorbidity Index (CCI). Treatment was classified as curative intent versus non-curative intent. The goals were 1) to demonstrate burden of comorbidity and 2) to demonstrate the impact of comorbidity on overall survival and selection of initial treatment in elderly HNC pts. Results: Pts characteristics: 100% male; 80% white, 19.5% Black, 0.5% Hispanic; median age 72y (range 65–87); 3% stage 0, 26% stage I, 20% stage II, 18% stage III, 30% stage IV, 2% unknown; primary site - 30% oral cavity, 4% hypopharnyx, 22% oropharynx, 38% larynx, 4% other, 1% unknown; treatment - 26% radiation only, 44% surgery (S), 21% chemoradiation (CR), 9% no treatment; Median CCI -2 (range 0–11); 61% had CCI score 0–2 and 39% had CI score > 3. Median overall survival was 883 days (SE 19.31 days). Rate of curative vs. non-curative intent treatment was 80% vs. 20% respectively. Pts with CCI score 0–2 had a non-significant higher rate of curative intent treatment than pts with CCI score > 3 (83.8% vs. 74.6% p = 0.13). In multivariate analysis including CCI, age, race, alcohol use, primary site, treatment, and stage, only advanced clinical stage had significant prognostic importance (HR 1.66; 95% CI, 1.29 to 2.14; p < 0.0005). The HR for CCI was 1.11 (95% CI, .99–1.24; p = 0.08). In separate multivariate analyses of pts treated with S and pts treated with CR, CCI was not a significant predictor of survival with HR of .88 (95% CI, .69–1.11; p = 0.29) and 1.13 (95% CI, .83–1.53; p = 0.44), respectively. Conclusions: In our population of elderly HNC pts, CCI and age had no significant impact on survival or selection of curative intent treatment. Additional study is required to better define appropriate candidates for curative intent treatment in this population. No significant financial relationships to disclose.

Analysis of Readmission After Autologous HCT: Predictive Factors and Clinical Consequences

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 932-932
Author(s):  
Sanjay R. Mohan ◽  
Lisa Rybicki ◽  
Stephen D. Smith ◽  
Robert Dean ◽  
Brad Pohlman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Overall Survival ◽  
Hodgkin Lymphoma ◽  
Hospital Readmission ◽  
Gastrointestinal Disorders ◽  
Readmission Rates ◽  
Platelet Recovery ◽  
Autologous Hct ◽  
One Year ◽  
The Impact

Abstract Abstract 932 With increasing scrutiny of healthcare expenditures, the reduction of hospital readmission rates has emerged as a targeted area of health reform; however, readmission rates following hematopoietic cell transplantation (HCT) have not been systematically examined. Whereas patients (pts) undergoing allogeneic HCT at increased risk of toxicity and mortality can be identified by their coexistent medical comorbidities as calculated by the HCT-comorbidity index (HCT-CI), the impact of such pre-HCT characteristics on outcome following high dose chemotherapy with autologous HCT is not known. We retrospectively analyzed the association of pre-transplantation HCT-CI with readmission rates and survival for all pts who underwent autologous HCT at a single institution from 1/2004 to 12/2008. Of 475 pts who underwent an autologous HCT, 62% were male and the median age was 52 years (range 20–75). Diagnoses were non-Hodgkin lymphoma (n=253, 53%), multiple myeloma (MM, 124, 26%), Hodgkin lymphoma (82, 17%), and other hematologic disorders (16, 3%). Forty-seven pts (10%) underwent a second autologous HCT as part of a planned tandem transplantation protocol; readmission and survival were calculated from the time of the first HCT. A total of 193 pts (41%) had a comorbidity score of 0, according to HCT-CI, 146 (31%) had a score of 1 to 2, and 136 (29%) had a score of 3 or greater. The preparative regimens included busulfan, cyclophosphamide, and etoposide (323, 68%), melphalan (86, 18%), and busulfan with cyclophosphamide (66, 14%). The median time to neutrophil recovery was 10 days and to platelet recovery was 14 days. The mean length of hospitalization was 20 +/− 4 days. Overall, 14% of patients were readmitted within 30 days of discharge, 21% within 100 days, and 30% within one year. Within the first 30 days post-HCT, infection (62%) and gastrointestinal disorders (22%) accounted for the majority of hospital readmissions. Infection (42%) was also the most frequent reason for readmission within one year, followed by gastrointestinal disorders (16%), relapsed malignancy (14%), and cardiopulmonary disease (9%). By stepwise logistic regression analysis, high pretransplantation HCT-CI (score ≥ 3) was predictive of hospital readmission within 30 days (odds ratio [OR] 2.08, 95% confidence interval [CI] 1.09–3.95, p=.026), 100 days (OR 1.93, 95% CI 1.14.-3.26, p=.014), and one year (OR 1.68, 95% CI 1.04–2.70, p=.034) of HCT discharge. Older age was also prognostic; each ten year increase in age at time of autologous HCT led to an increased likelihood of 30 day readmission (OR 1.36, 95% CI 1.07–1.73, p=.014). A model for probability of post-autologous HCT readmission was constructed using these multivariable risk factors (Table 1). Cox proportional hazards analysis was used to identify prognostic factors for overall survival. In univariable analysis, high HCT-CI, diagnosis, preparative regimen, and readmission were risk factors for mortality, but in stepwise multivariable analysis, only diagnosis (MM vs other diagnoses, hazard ratio [HR] .61, 95% CI .40-.92, p=.018) and readmission (HR 3.97, 95% CI 2.85–5.52, p<.001) remained prognostic for overall survival. We conclude that both age and comorbidity status influence readmission rates following autologous HCT. Importantly, readmission is strongly associated with a greater risk of mortality, a link that should be further investigated. HCT-CI scores should be calculated for all autologous HCT pts, which may allow for improved comparison of outcomes and readmission data between institutions and provide opportunities to further increase the safety of autologus HCT. Disclosures: No relevant conflicts of interest to declare.

The Impact of Continuity of Care On Survival Outcomes After Allogeneic Hematopoietic Stem Cell Transplantation; Improved Overall Survival in the Absence of Severe Graft Vs. Host Disease

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4521-4521
Author(s):  
Yasser Khaled ◽  
Melhem M. Solh ◽  
Robert B. Reynolds ◽  
Carlos Alemany ◽  
Raul Castillo ◽  
...  
Keyword(s):  
Overall Survival ◽  
Continuity Of Care ◽  
Cumulative Incidence ◽  
Older Patients ◽  
Patient Characteristics ◽  
Hematopoietic Stem ◽  
Graft Vs Host Disease ◽  
One Year ◽  
The Impact ◽  
Grade Iii

Abstract Abstract 4521 Continuity of care (COC) is acknowledged as a core quality measure in HIV, heart failure and family medicine. Allogeneic hematopoietic stem cell transplantation (Allo-HCT) is complex therapeutic option where is the selection of patient, donor, conditioning and immune-suppression plays a pivotal role in overall survival (OS) outcome. Although the team concept is an integral part of care in Allo-HCT, there is little literature known about the impact of personnel COC (care from the same provider) on OS. Method: Between July 2009 and May 2012, 74 consecutive Allo-HCT were performed at our center. The patient's clinical care for the first consecutive 41 patients was shared between the physicians independent of primary transplant physician (Non- COC group). To assess the impact of COC on OS after Allo-HCT, the subsequent 33 patients (COC group) were followed by their transplant physician both as in-patient and outpatient. Physician's contribution into the care of each individual patient was calculated from physicians billing visits. Patient characteristics of COC & Non-COC groups are shown in table I. Graft vs. host disease (GVHD) prophylaxis was Tacrolimus/MTX or Cyclosporine/Mycophenolate with the addition of Thymoglobulin for MUD and mismatched RD. Results: The average contribution of the primary transplant physician into their patients care during year one post-transplant was 49% vs. 80% for Non-COC and COC groups respectively (P=0.01). There was no difference in patient characteristics between COC and Non-COC groups except for older patients in Non-COC. With median duration of follow up of 815 days for Non-COC and 320 days for COC groups, the 1- year OS was 56% vs. 75% respectively (P=0.07). Similarly, there was a trend toward improved DFS for COC (1-year DFS of 68% vs. 48%, P=0.11). On Univariate analysis, Age (≤ 55, P=0.26), Donor source (MUD vs. RD, p=0.65), diagnosis (acute leukemia vs. other, p=0.18), status at transplant (P= 0.23), cytogenetic risk (p=0.79) and conditioning (FIC vs. RIC, p=0.62) were not predictive of improved OS. Both cumulative incidence of relapse and treatment related mortality (TRM) at 1-year were lower in COC compared to Non-COC groups; 9.5% vs. 25% and 17% vs. 25% respectively. The cumulative incidence of grade II –IV acute GVHD (aGVHD) at day 100 and day 180 was 64% & 64% for Non-COC vs. 46% & 72% for COC respectively. There was more patients with grade III/IV aGVHD; 13/41 (32%) in Non-COC compared to 6/33(18%) in COC, however this difference was not statistically significant (p=0.27). Additionally, there was no difference in OS in patients with grade III/IV aGVHD in Non-COC (13 patients) vs. COC (6 patients), P=0.85. In contrast, Patients without grade III/IV aGVHD had a statistical OS advantage in favor of COC (27 patients) vs. Non-COC (28 patients) with one year OS of 90% vs. 68% respectively, P=0.05. Cumulative incidence of chronic GVHD at one year was 77% for COC and 48% for Non-COC patients, P=0.02. Conclusion: Physician-Patient continuity of care may favorably impact OS in Allo-HCT for hematological malignancy. The reason for lower relapse and TRM in COC group is unclear but could be attributed to older patients and differences in aGVHD management in Non-COC group. In this small study, COC did not impact OS in patients with severe aGVHD but may result in OS advantage in Allo-HCT patients without grade III/IV aGVHD. Larger studies are needed to address the impact of COC on outcomes after Allo-HCT. Disclosures: Khaled: Celgene and Takeda Pharmacutical: Honoraria, Speakers Bureau. Solh:Celgene: Speakers Bureau.

scholarly journals Time interval between (chemo)radiotherapy and subsequent laryngectomy is not prognostic for post operative complications and survival

2020 ◽  
Author(s):  
Thomas F. Pézier ◽  
Johannes A. Rijken ◽  
Bernard M. Tijink ◽  
W. Weibel Braunius ◽  
Remco de Bree
Keyword(s):  
Overall Survival ◽  
Total Laryngectomy ◽  
Medical Center ◽  
Time Interval ◽  
Pharyngocutaneous Fistula ◽  
Retrospective Case ◽  
Rate Risk ◽  
Swallowing Difficulties ◽  
One Year ◽  
The Impact

Abstract Purpose Pharyngocutaneous fistula (PCF) formation and swallowing difficulties are common and troublesome complications following total laryngectomy (TL). Prior (chemo)radiotherapy ((C)RT) is thought to be a risk factor for these complications, but there is conflicting evidence as to whether the time interval between (C)RT and TL is important. The impact of time interval on these complications and also its impact on overall survival are investigated. Methods This is a retrospective case note review of all patients undergoing TL at the University Medical Center, Utrecht, The Netherlands over the 10-year period from January 2008 to December 2017. The cohort was split into those who underwent TL within a year of finishing (C)RT and those longer than 1 year. Results One hundred and twenty-six patients (108 males, 18 females), with a mean age of 66 underwent total laryngectomy after prior (C)RT in the study period. Overall 5-year survival was 35% with a median follow-up of 30 months. Fifty-four patients underwent laryngectomy within a year of their (C)RT versus 72 patients who had a time interval of more than one year. No differences in PCF rate, risk of dilatation or overall survival could be found between the two groups. Conclusions In this modern cohort, time interval between (C)RT and surgery did not impact PCF rate, risk of dilatation or overall survival.

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