Am J Otolaryngol Head Neck Surg | Volume 7, Issue 1 | Research Article | Open Access

Impact of Delay in Treatment Initiation in Overall Survival in Head and Neck Cancer

Amarillo D1*, Herrera G2, Lara G2, Muñóz E2, Sanchez S2, Sommer P2, Sosa S2, Alvarez D3, Borche G3, Munyo A3, Lorenzo F3, Albora RD3 and Cuello M1

1Department of Medical Oncology, Hospital de Clinicas, Montevideo, Uruguay
2University of the Republic, Montevideo, Uruguay
3Department of ENT, Hospital de Clínicas, Montevideo, Uruguay

*Correspondance to: Dahiana Amarillo 

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Introduction: The purpose of our study was to identify the impact the delay from diagnosis to treatment interval has on Overall Survival (OS) in head and neck cancer patients.
Materials and Methods: We performed a retrospective study of head and neck cancer patients diagnosed in the “Hospital de Clinicas” in Montevideo, Uruguay, between 2005-2015. Recursive partitioning analysis was used to find the prognostic cut off of Diagnosis to Treatment Interval (DTI) that affects survival.
Results: We identified a prognostic cut off time that differentiates OS in 40.5 days. Median OS was 36.16 months for patients with DTI ≤ 40.5 days, and 23.14 months for DTI >40.5 days (p=0.006). In localized disease median OS was 116.3 months for DTI ≤ 40.5 days vs. 55 months for DTI >40.5 days. In advanced is ease they were 27.6 vs. 21.1 months respectively (p=0.009). In laryngeal cancer median OS was 70.58 months for ≤ 40.5 days vs. 27.75 months for DTI >40.5 days. The difference was more pronounced in patient treated with radiotherapy (35.7 vs. 21.1 months) than in treated with surgery (34.2 vs. 49.9 months) (p=0.041). Multivariable analysis found that sex, DTI, site and tumor stage impact on the survival.
Conclusion: A DTI greater than 40.5 days is associated with worse OS in patients with head and neck tumors, independently of the treatment received, the stage and the anatomic site of the primary tumor.


Treatment delay; Head and neck cancer; Diagnostic to treatment interval, Uruguay


Amarillo D, Herrera G, Lara G, Muñóz E, Sanchez S, Sommer P, et al. Impact of Delay in Treatment Initiation in Overall Survival in Head and Neck Cancer. Am J Otolaryngol Head Neck Surg. 2024; 7(1): 1256..

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