Prognostic significance of diagnosis-to-surgery interval in oral cavity squamous cell carcinoma: A nationwide study.
Journal
Oral oncology
Journal Volume
161
Start Page
Article number 107196
ISSN
1879-0593
Date Issued
2025-02
Author(s)
Kang, Chung-Jan
Wen, Yu-Wen
Lin, Chien-Yu
Ng, Shu-Hang
Tsai, Yao-Te
Ku, Hsiu-Ying
Lin, Jin-Ching
Hua, Chun-Hung
Lee, Shu-Ru
Fan, Kang-Hsing
Chen, Wen-Cheng
Lee, Li-Yu
Chien, Chih-Yen
Chen, Tsung-Ming
Terng, Shyuang-Der
Tsai, Chi-Ying
Wang, Hung-Ming
Hsieh, Chia-Hsun
Yeh, Chih-Hua
Lin, Chih-Hung
Tsao, Chung-Kan
Cheng, Nai-Ming
Fang, Tuan-Jen
Huang, Shiang-Fu
Lee, Li-Ang
Fang, Ku-Hao
Wang, Yu-Chien
Lin, Wan-Ni
Hsin, Li-Jen
Yen, Tzu-Chen
Liao, Chun-Ta
Abstract
Background: The question as to whether prolonged diagnosis-to-surgery intervals (DSIs) may compromise survival outcomes in patients with oral cavity squamous cell carcinoma (OCSCC) remains unanswered. This nationwide study was designed to address this issue. Methods: We analyzed data from 26,214 patients with first primary OCSCC identified in the Taiwanese Cancer Registry Database between 2011 and 2021. The optimal DSI cutoff was determined based on 5-year disease-specific survival (DSS) and overall survival (OS) rates using Cox regression analysis. Patients were categorized into three distinct DSI groups: ≤20 days (47 %), 21–31 days (31 %), and > 31 days (22 %). Results: The 5-year DSS and OS rates for the ≤20/21–31/>31 days groups were 81 %/78 %/77 % and 73 %/70 %/68 %, respectively (both p < 0.0001). Patients in the ≤20 days group had a higher prevalence of pathological stages I–II. After adjustment for potential confounders in multivariable analysis, a DSI > 31 days (versus ≤ 20 days) retained independent associations with adverse outcomes at 5 years, with hazard ratios of 1.07 for both DSS and OS. Propensity score matching and multivariable analysis comparing DSI ≤ 20 days to DSI > 31 days stratified by pathological stage III–IV showed that higher DSS and OS rates were observed in patients with DSI ≤ 20 days than DSI > 31 days (68 %/66 %, p = 0.0586; 60 %/57 %, p = 0.0228, respectively), with hazard ratios of 1.09 for both DSS and OS. Conclusions: Our findings indicate that DSI is an independent predictor of 5-year DSS and OS in patients with OCSCC. A DSI exceeding 31 days, or even 21 days, may potentially decrease survival outcomes.
Subjects
Cancer registry
Diagnosis-to-surgery interval
Disease-specific survival
Nationwide study
Oral cavity squamous cell carcinoma
Overall survival
Treatment delay
SDGs
Type
journal article