To examine the clinical relevance of the 42-day postoperative radiotherapy (PORT) benchmark and identify factors associated with delayed or omitted treatment in adults with nonmetastatic pT4 laryngeal squamous cell carcinoma treated by total laryngectomy.
Approach:
Study Design: A retrospective cohort analysis using National Cancer Database (NCDB) data from January 1, 2010, to December 31, 2022.
Study Population: Adults aged ≥18 years with invasive, nonmetastatic laryngeal SCC who underwent total laryngectomy, radical laryngectomy, or pharyngolaryngectomy.
Outcomes and Measures: The interval from surgery to PORT was measured, with benchmark failure defined as PORT initiation more than 42 days postoperatively.
Statistical Analysis: Multivariable logistic regression was used to evaluate factors associated with failure to meet the PORT benchmark.
Key Findings:
Approximately 49% of patients with HNSCC in the U.S. started PORT more than 6 weeks after surgery, according to a meta-analysis.
The mean time-to-PORT was nearly 47 days, as reported in the literature.
Delays in PORT initiation were attributed to various socioeconomic and clinical factors, as noted in previous studies.
Interpretation:
The study examines the challenges in achieving timely PORT following total laryngectomy, highlighting the need for procedure-specific evaluations.
Limitations:
The study is limited to data from the NCDB, which may not capture all relevant clinical factors.
Findings may not be generalizable to all head and neck cancer patients due to the focus on laryngeal carcinoma.
Conclusion:
Understanding factors influencing PORT timing is crucial for improving treatment processes for patients with pT4 laryngeal carcinoma.
by George Ashji, Arun Rajan, Elias Dahl, Sudarshan Ramanan, Nishant Chadha, Yingzhi Wu, Richard J. Wong, Marc A. Cohen, Edward Christopher Dee, Nancy Y. Lee
U.S. News & World Report has recognized Dana-Farber/Boston Children’s Cancer and Blood Disorders Center as the #1 pediatric cancer program in the nation in its 2026-2027 Best Children’s Hospitals report.
