Characterizing Treatment Delays in Patients With HPV-Negative Oropharyngeal Cancer

Area of Science:

• Oncology
• Head and Neck Surgery
• Public Health

Background:

• The impact of treatment initiation delays on oropharyngeal squamous cell carcinoma (OPSCC) outcomes is known, but mechanisms for delay in HPV-negative OPSCC are unclear.
• Understanding factors contributing to delayed treatment is crucial for improving patient care and outcomes in HPV-negative OPSCC.

Purpose of the Study:

• To investigate sociodemographic factors and treatment timelines associated with delayed treatment initiation in HPV-negative OPSCC patients.
• To identify predictors of extended time to treatment initiation (TTI) in this specific patient population.

Main Methods:

• Retrospective chart review of 76 patients with HPV-negative OPSCC treated between 2013-2023.
• Dichotomization of patients based on the median TTI (53.5 days); comparison of clinical timelines using descriptive statistics and Mann-Whitney U testing.
• Multivariate logistic regression to identify independent predictors of delayed TTI, reporting adjusted odds ratios (aORs) and 95% confidence intervals.

Main Results:

• Male sex (aOR 3.28), unmarried status (aOR 5.96), and biopsy availability before arrival (aOR 4.08) were independently associated with delayed treatment initiation.
• Primary chemoradiation (aOR 0.25) was associated with shorter TTI compared to surgery.
• Significant differences in biopsy-to-referral and PET scan-to-treatment intervals were observed between delayed and non-delayed groups.

Conclusions:

• Primary nonsurgical treatment and lack of social support are independently associated with treatment delays in HPV-negative OPSCC.
• Findings suggest targeted interventions to mitigate delays and improve care delivery for HPV-negative OPSCC patients.
• Opportunities exist for specialty-level improvements in managing treatment timelines for HPV-negative OPSCC.