Dept. of Oncology, Odense University Hospital, Denmark.
Dept. of Experimental Clinical Oncology, Aarhus University Hospital, Dept. of Oncology, Odense University Hospital, Denmark.
J Geriatr Oncol. 2019 Mar;10(2):259-264. doi: 10.1016/j.jgo.2018.06.003. Epub 2018 Jun 25.
Fast-track programs for diagnostic work-up and start of cancer treatment are defined by legislation in Denmark. The aim was to examine whether age, comorbidity or WHO performance status influence the time from referral due to suspicion of cancer to start of treatment (waiting time) in the Danish fast-track program.
For this descriptive cohort study, consecutive head and neck cancer (HNC) patients who underwent radiotherapy or surgery from January 2014 to July 2016 at Odense University Hospital (OUH) were identified in the database of the Danish Head and Neck Cancer group (DAHANCA). Age (<70 vs. ≥70 years), comorbidity (none vs. any), and WHO performance status (0-1 vs. 2-4) were correlated to waiting time.
In total, 650 HNC-patients were included and of those, 92% were discussed at the multidisciplinary team conference. Patients ≥70 years were less frequently discussed in a multidisciplinary setting compared to younger patients (88% vs. 93%, p < 0.05). The time spent for diagnostic workup and treatment planning (waiting time) was longer for patients having primary radiotherapy than for primary surgery (p < 0.001), and 21% of patients treated with primary radiation exceeded the recommended maximum waiting time, whereas this was the case for only 7% of the patients treated with primary surgery. However, age ≥ 70 years, presence of comorbidity or poor performance status did not significantly influence the waiting time.
Age ≥ 70 years, comorbidity and poor WHO performance status did not influence the waiting time among patients with head and neck cancer treated at OUH.
丹麦立法规定了诊断工作和癌症治疗启动的快速通道计划。本研究旨在探讨年龄、合并症或世界卫生组织（WHO）体能状态是否会影响丹麦快速通道计划中因疑似癌症而转诊至开始治疗的时间（等待时间）。
本描述性队列研究连续纳入了 2014 年 1 月至 2016 年 7 月在欧登塞大学医院（OUH）接受放疗或手术的头颈部癌症（HNC）患者，这些患者的信息来自丹麦头颈部癌症组（DAHANCA）数据库。分析年龄（<70 岁与≥70 岁）、合并症（无 vs. 有）和 WHO 体能状态（0-1 分与 2-4 分）与等待时间的相关性。
共纳入 650 例 HNC 患者，其中 92%的患者在多学科团队会议上进行了讨论。与年轻患者相比，≥70 岁的患者在多学科环境中讨论的频率较低（88%比 93%，p<0.05）。与接受根治性手术的患者相比，接受根治性放疗的患者的诊断性检查和治疗计划时间（等待时间）更长（p<0.001），并且 21%的接受根治性放疗的患者超过了推荐的最长等待时间，而仅 7%的接受根治性手术的患者超过了这一标准。然而，年龄≥70 岁、合并症或较差的 WHO 体能状态并未显著影响等待时间。
在 OUH 接受治疗的头颈部癌症患者中，年龄≥70 岁、合并症和较差的 WHO 体能状态并不影响等待时间。
