Cherupalla Balaji, Warren James, Kane Anne, Trendle Michael, Tassone Patrick
University of Missouri, 1 Hospital Dr., Columbia, MO 65212, United States of America.
University of Mississippi Medical Center, Jackson, MS - 2500 N State St, Jackson, MS 39216, United States of America.
Am J Otolaryngol. 2024 Jan-Feb;45(1):104051. doi: 10.1016/j.amjoto.2023.104051. Epub 2023 Sep 18.
Factors that are associated with failure to receive guideline-compliant adjuvant chemotherapy after resection of high-risk oral cavity cancer are understudied. Here, we performed a retrospective cohort study of surgically treated patients with oral cavity squamous cell carcinoma to determine rates of guideline-compliant adjuvant chemotherapy and to examine patient factors associated with receiving guideline-compliant chemotherapy.
Retrospective cohort.
Two tertiary care referral centers.
Patients with resected high-risk oral cavity squamous cell carcinoma and known adjuvant therapy details were included. Extranodal extension or positive margins were considered high-risk features for which adjuvant chemoradiation was indicated. Patient factors were examined to determine associations with receiving on-guidelines treatment. Univariable and multivariable logistic regression were used to determine significance of associations.
75 patients were included. 36 (48 %) patients received guideline-compliant cisplatin. In total, 39 (52 %) patients did not receive guideline-compliant chemotherapy. On multivariable analysis, meeting with a university medical oncologist was significantly associated with the receipt of guideline-compliant cisplatin (OR 6.38, 95 % CI 2.26-20.0, p < 0.001).
Adherence to on-guidelines treatment can be difficult to achieve in patients with advanced stage head and neck cancer. Meeting with university medical oncology is associated with an increased chance of receiving guideline-compliant chemotherapy.
高危口腔癌切除术后未接受符合指南的辅助化疗的相关因素研究不足。在此，我们对接受手术治疗的口腔鳞状细胞癌患者进行了一项回顾性队列研究，以确定符合指南的辅助化疗率，并检查与接受符合指南化疗相关的患者因素。
回顾性队列研究。
两个三级医疗转诊中心。
纳入已切除高危口腔鳞状细胞癌且已知辅助治疗细节的患者。淋巴结外侵犯或切缘阳性被视为需要辅助放化疗的高危特征。检查患者因素以确定与接受符合指南治疗的相关性。采用单变量和多变量逻辑回归确定相关性的显著性。
共纳入75例患者。36例（48%）患者接受了符合指南的顺铂治疗。总共有39例（52%）患者未接受符合指南的化疗。多变量分析显示，与大学医学肿瘤学家会诊与接受符合指南的顺铂治疗显著相关（比值比6.38，95%置信区间2.26 - 20.0，p < 0.001）。
晚期头颈癌患者难以实现遵循指南的治疗。与大学医学肿瘤学家会诊与接受符合指南化疗的机会增加相关。
