Kiș Andreea Mihaela, Buzatu Roxana, Chisavu Lazar, Poenaru Marioara, Borza Claudia, Iftode Andrada, Sarau Oana Silvana, Dehelean Cristina Adriana, Ardelean Simona
Faculty of Pharmacy, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timișoara, Romania.
Research Center for Pharmaco-Toxicological Evaluations, Faculty of Pharmacy, "Victor Babeș" University of Medicine and Pharmacy, 300041 Timișoara, Romania.
Clin Pract. 2024 Jun 29;14(4):1270-1284. doi: 10.3390/clinpract14040103.
Diagnosis and treatment for pharyngeal cancer are decisive in determining prognosis. Diagnosis delays are frequent, representing a significant cause of avoidable mortality, and an important factor in subpar survival across the continuous HNC care delivery.
The present study represents a retrospective analysis of medical records from Western Romania, which included 180 patients, to evaluate the impact of time-to-treatment delay on patients diagnosed with pharyngeal cancer. The data analyses were performed using the Kaplan-Meier method R (version 3.6.3) packages, including tidyverse, final-fit, mcgv, survival, stringdist, janitor, and Hmisc.
The mean days from diagnosis until the end of treatment were higher for the nasopharynx group. Cox regression analysis regarding diagnosis to treatment duration categories showed an increased risk mortality by 3.11 times (95%CI: 1.51-6.41, 0.0021) with a Harrell's C-index of 0.638 (95%CI: 0.552-0.723). The hypopharynx and oropharynx locations increased risk mortality by 4.59 (95%CI: 1.55-13.55) and 5.49 times (95%CI: 1.79-16.81) compared to the nasopharynx location.
The findings of this study led to the conclusion that it seems there is a trend of mortality risk for oropharynx and hypopharynx cancers due to delays in the time to treatment over 70 days, standing as a basis for further research as there is an imperative need for prospective multicenter studies.
咽喉癌的诊断和治疗对预后起着决定性作用。诊断延迟很常见，是可避免死亡的重要原因，也是整个头颈癌连续护理过程中生存质量欠佳的一个重要因素。
本研究对罗马尼亚西部180例患者的病历进行回顾性分析，以评估治疗延迟时间对咽喉癌确诊患者的影响。数据分析使用R（版本3.6.3）软件包中的Kaplan-Meier方法，包括tidyverse、final-fit、mcgv、survival、stringdist、janitor和Hmisc。
鼻咽癌组从诊断到治疗结束的平均天数更高。关于诊断到治疗持续时间类别的Cox回归分析显示，死亡风险增加3.11倍（95%置信区间：1.51 - 6.41，P = 0.0021），Harrell's C指数为0.638（95%置信区间：0.552 - 0.723）。与鼻咽癌部位相比，下咽和口咽部位的死亡风险分别增加4.59倍（95%置信区间：1.55 - 13.55）和5.49倍（95%置信区间：1.79 - 16.81）。
本研究结果得出结论，由于治疗延迟超过70天，口咽癌和下咽癌似乎存在死亡风险趋势，鉴于迫切需要进行前瞻性多中心研究，这可作为进一步研究的基础。
