Less Is More? The Association between Survival and Follow-Up Protocol after Treatment in Oral Cavity Cancer Patients from a Betel Quid-Prevalent Region

The optimal follow-up protocol after treatment of oral cavity cancer patients is still debatable. We aimed to investigate the impact of frequency of different imaging studies and follow-up visits on the survival of oral cavity cancer patients. The current study retrospectively reviewed oral cavity cancer patients who underwent surgical intervention in our hospital. Basic demographic data, tumor-related features, treatment modalities, imaging studies, and clinic visits were recorded. Cox proportional hazard model was used to examine the influence of variables on the survival of oral cavity cancer patients. In total, 741 patients with newly diagnosed oral cavity cancer were included in the final analysis. Overall, the frequency of imaging studies was not associated with survival in the multivariate analysis, except PET scan (hazard ratio [HR]: 5.30, 95% confidence interval [CI]: 3.57–7.86). However, in late-stage and elder patients, frequent head and neck CT/MRI scan was associated with a better prognosis (HR: 0.55, 95% CI: 0.36–0.84; HR: 0.52, 95% CI: 0.30–0.91, respectively). In conclusion, precision medicine is a global trend nowadays. Different subgroups may need different follow-up protocols. Further prospective study is warranted to clarify the relationship between frequency of image studies and survival of oral cavity cancer patients.

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The impact of seasonal operating room closures on wait times for oral cancer surgery

Current Oncology ◽

10.3747/co.25.3726 ◽

2018 ◽

Vol 25 (1) ◽

pp. 67 ◽

Cited By ~ 4

Author(s):

N. Mundi ◽

J. Theurer ◽

A. Warner ◽

J. Yoo ◽

K. Fung ◽

...

Keyword(s):

Oral Cavity ◽

Cancer Patients ◽

Operating Room ◽

Oral Cavity Cancer ◽

Tertiary Care ◽

Wait Time ◽

Disease Recurrence ◽

Health Science ◽

Wait Times ◽

The Impact

Background Operating room slowdowns occur at specific intervals in the year as a cost-saving measure. We aim to investigate the impact of these slowdowns on the care of oral cavity cancer patients at a Canadian tertiary care centre.Methods A total of 585 oral cavity cancer patients seen between 1999 and 2015 at the London Health Science Centre (lhsc) Head and Neck Multidisciplinary Clinic were included in this study. Operating room hours and patient load from 2006 to 2014 were calculated. Our primary endpoint was the wait time from consultation to definitive surgery. Exposure variables were defined according to wait time intervals occurring during time periods with reduced operating room hours.Results Overall case volume rose significantly from 2006 to 2014 (p < 0.001), while operating room hours remained stable (p = 0.555). Patient wait times for surgery increased from 16.3 days prior to 2003 to 25.5 days in 2015 (p = 0.008). Significant variability in operating room hours was observed by month, with lowest reported for July and August (p = 0.002). The greater the exposure to these months, the more likely patients were to wait longer than 28 days for surgery (odds ratio per day [or]: 1.07, 95% confidence interval [ci]: 1.05 to 1.10, p < 0.001). Individuals seen in consultation preceding a month with below average operating room hours had a higher risk of disease recurrence and/or death (hazard ratio [hr]: 1.59, 95% ci: 1.10 to 2.30, p = 0.014).Conclusions Scheduled reductions in available operating room hours contribute to prolonged wait times and higher disease recurrence. Further work is needed to identify strategies maximizing efficient use of health care resources without negatively affecting patient outcomes.

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Cost-Identification Analysis in Oral Cavity Cancer Management

Otolaryngology ◽

10.1016/s0194-5998(98)80018-1 ◽

1998 ◽

Vol 118 (2) ◽

pp. 211-220 ◽

Cited By ~ 18

Author(s):

Gerry F. Funk ◽

Henry T. Hoffman ◽

Lucy Hynds Karnell ◽

Joan M. Ricks ◽

M. Bridget Zimmerman ◽

...

Keyword(s):

Resource Allocation ◽

Oral Cavity ◽

Oral Cavity Cancer ◽

Smoking History ◽

Hospital Charges ◽

Treatment Modalities ◽

Independent Variables ◽

Wide Range ◽

Patient Mix

The objectives of this study were to investigate potential relationships between pretreatment patient-mix characteristics, treatment modalities, and costs generated during the pretreatment work-up, treatment, and 1-year follow-up periods for patients with oral cavity cancer (OCC). Another objective was to identify potential areas for cost reduction and improved resource allocation in the management of OCC patients. Using a retrospective cohort of 73 patients with OCC, pretreatment patient-mix characteristics and treatment modalities were evaluated in relation to university-based charges incurred during the pretreatment evaluation, treatment, and 1 -year follow-up periods. Simple regression and stepwise multiple regression analyses were used to develop predictive models for cost based on independent variables, including age, AJCC TNM clinical stage, smoking history, American Society of Anesthesiologists (ASA) class, comorbidity as defined by the Kaplan-Feinstein grade and treatment modality. The dependent measurements included all physician, office, and hospital charges incurred at the University of Iowa Hospitals and Clinics during the pretreatment evaluation, treatment, and follow-up periods, as well as the total pretreatment through 1-year follow-up management costs. Independent variables that were identified as being significantly associated with treatment costs included T classification, N classification, TNM stage, unimodality versus multimodality treatment, and the Kaplan-Feinstein comorbidity grade. Age, smoking status, and ASA class were not significantly associated with costs. The majority of the OCC management costs were incurred during the treatment period. The most substantial decreases in management costs for OCC will be realized through measures that allow identification and treatment of disease at an early stage, in which single-modality treatment may effectively be used. Resource allocation for OCC should support the investigation of measures through which the diagnosis and treatment of OCC at the earliest possible stage is facilitated. The presence of comorbid illness is a significant component in the determination of management costs for OCC and should be included in analyses of resource allocation for OCC. The singular diagnosis of OCC encompasses a wide range of patient illness severity, and diagnosis-related reimbursement schemes for OCC treatment should optimally differentiate between early and advanced stage disease.

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Application of proximity ligation assays to identify potential plasma biomarkers in oral cavity cancer patients: A case control study

Cancer Biomarkers ◽

10.3233/cbm-191195 ◽

2020 ◽

Vol 29 (1) ◽

pp. 17-23 ◽

Cited By ~ 1

Author(s):

Jin-Ching Lin ◽

Chen-Chi Wang ◽

Rong-San Jiang ◽

Wen-Yi Wang ◽

Shih-An Liu

Keyword(s):

Oral Cavity ◽

Cancer Patients ◽

Oral Cavity Cancer ◽

Final Analysis ◽

Proximity Ligation Assay ◽

Proximity Ligation ◽

Ct Value ◽

Healthy Participants ◽

Control Study ◽

E Cadherin

BACKGROUND: Practical cancer biomarkers for oral cavity cancer are currently in limited use. OBJECTIVE: We aimed to investigate the differences in soluble E-cadherin between patients with oral cavity cancer and matched healthy participants via Proximity Ligation Assay (PLA). METHODS: Samples were taken from both patients diagnosed with oral cavity cancer, as well as non-cancerous participants. PLA was used to detect soluble E-cadherin and Cycle threshold (Ct) values derived from qPCR in order to calculate the number of starting amplicons. RESULTS: In total, 74 patients with oral cavity cancer and 55 matched non-cancerous participants were included for final analysis. The Ct value of E-cadherin was found to be lower in oral cavity cancer patients when compared with that of the matched non-cancerous participants (20.72 ± 0.39 versus 21.27 ± 0.45, P< 0.001). Using a Ct value of 20.9 as a cut-off point, the sensitivity and specificity of discriminating patients with oral cavity cancer from the healthy controls was 63.5% and 87.3%, respectively. CONCLUSION: Plasma soluble E-cadherin levels were significantly higher in patients with oral cavity cancer when compared with those from the matched non-cancerous participants.

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The Impact of Hospital Safety-Net Burden on Survival Outcomes in Oral Cavity Cancer Patients

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2020.02.560 ◽

2020 ◽

Vol 108 (2) ◽

pp. E40

Author(s):

Minh T. Truong ◽

Christa Lam ◽

Muhammad Mustafa Qureshi

Keyword(s):

Oral Cavity ◽

Cancer Patients ◽

Oral Cavity Cancer ◽

Safety Net ◽

Survival Outcomes ◽

Hospital Safety ◽

The Impact

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The impact of superficial injections of radiocolloids and dynamic lymphoscintigraphy on sentinel node identification in oral cavity cancer: a same-day protocol

Nuclear Medicine Communications ◽

10.1097/mnm.0b013e3282f4d399 ◽

2008 ◽

Vol 29 (4) ◽

pp. 318-322 ◽

Cited By ~ 14

Author(s):

Girolamo Tartaglione ◽

Maurizio G. Vigili ◽

Siavash Rahimi ◽

Alessandra Celebrini ◽

Marco Pagan ◽

...

Keyword(s):

Oral Cavity ◽

Sentinel Node ◽

Oral Cavity Cancer ◽

Sentinel Node Identification ◽

The Impact

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Risk Factors for Wound Infection After Surgery in Primary Oral Cavity Cancer Patients

The Laryngoscope ◽

10.1097/01.mlg.0000249737.05840.29 ◽

2007 ◽

Vol 117 (1) ◽

pp. 166-171 ◽

Cited By ~ 59

Author(s):

Shih-An Liu ◽

Yong-Kie Wong ◽

Chiu-Kwan Poon ◽

Chen-Chi Wang ◽

Ching-Ping Wang ◽

...

Keyword(s):

Risk Factors ◽

Oral Cavity ◽

Wound Infection ◽

Cancer Patients ◽

Oral Cavity Cancer

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Impact of microsatellite alteration in surgical margins on local recurrence in oral cavity cancer patients

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s00405-016-4215-y ◽

2016 ◽

Vol 274 (1) ◽

pp. 431-439 ◽

Cited By ~ 3

Author(s):

Jin-Ching Lin ◽

Chen-Chi Wang ◽

Rong-San Jiang ◽

Wen-Yi Wang ◽

Shih-An Liu

Keyword(s):

Local Recurrence ◽

Oral Cavity ◽

Cancer Patients ◽

Oral Cavity Cancer ◽

Surgical Margins

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Utility of telemedicine in COVID-19 pandemic: our experience at a tertiary cancer center in North East India

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20204898 ◽

2020 ◽

Vol 8 (11) ◽

pp. 4027

Author(s):

Ashok Kumar Das ◽

Sumanjit S. Boro ◽

Anupam Das ◽

Partha Pratim Medhi ◽

Kaberi Kakati ◽

...

Keyword(s):

Cancer Patients ◽

Task Force ◽

Demographic Data ◽

Cross Sectional Study ◽

Cancer Center ◽

Cross Sectional ◽

Ongoing Treatment ◽

North East ◽

Phone Calls

Background: Telemedicine is a very useful tool of communication between the doctor and the patient. The aim of this study was to find out the utility of telemedicine during the lockdown period of COVID-19 pandemic in North East India.Methods: It is a cross sectional study among the cancer patients at our center on follow up or ongoing treatment and analysis of all the data acquired from telephonic conversation with our patients from 30th March, 2020 to 3rd May, 2020. Have contacted 4181 patients during this period over phone. All phone calls were done by respective department doctors.Results: From the demographic data, we get that 35.4% of patients were at good physical condition, 3.5% with poor general condition, 11.6% patients having ongoing treatment in our institute, 21.1% patients expired, 0.9% patients have nonmalignant diagnosis, 1.4% patients left the institute due to various reasons. Analyzed this data with brain storming sessions amongst the COVID-19 task force doctors and tried to find out solutions of each problem.Conclusions: Telemedicine cannot replace conventional method of in person treatment, but it proved to be a useful tool during the COVID-19 pandemic for patient follow up and treatment of cancer patients.

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