Kang Chung-Jan, Wen Yu-Wen, Lin Chien-Yu, Ng Shu-Hang, Tsai Yao-Te, Ku Hsiu-Ying, Lou Pei-Jen, Wang Cheng Ping, Lin Jin-Ching, Hua Chun-Hung, Lee Shu-Ru, Fan Kang-Hsing, Chen Wen-Cheng, Lee Li-Yu, Chien Chih-Yen, Chen Tsung-Ming, Terng Shyuang-Der, Tsai Chi-Ying, Wang Hung-Ming, Hsieh Chia-Hsun, Yeh Chih-Hua, Lin Chih-Hung, Tsao Chung-Kan, Cheng Nai-Ming, Fang Tuan-Jen, Huang Shiang-Fu, Lee Li-Ang, Fang Ku-Hao, Wang Yu-Chien, Lin Wan-Ni, Hsin Li-Jen, Yen Tzu-Chen, Liao Chun-Ta
Department of Otorhinolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, ROC.
Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan, Taiwan, ROC; Division of Thoracic Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC.
Oral Oncol. 2025 Feb;161:107196. doi: 10.1016/j.oraloncology.2025.107196. Epub 2025 Jan 21.
The question as to whether prolonged diagnosis-to-surgery intervals (DSIs) may compromise survival outcomes in patients with oral cavity squamous cell carcinoma (OCSCC) remains unanswered. This nationwide study was designed to address this issue.
We analyzed data from 26,214 patients with first primary OCSCC identified in the Taiwanese Cancer Registry Database between 2011 and 2021. The optimal DSI cutoff was determined based on 5-year disease-specific survival (DSS) and overall survival (OS) rates using Cox regression analysis. Patients were categorized into three distinct DSI groups: ≤20 days (47 %), 21-31 days (31 %), and > 31 days (22 %).
The 5-year DSS and OS rates for the ≤20/21-31/>31 days groups were 81 %/78 %/77 % and 73 %/70 %/68 %, respectively (both p < 0.0001). Patients in the ≤20 days group had a higher prevalence of pathological stages I-II. After adjustment for potential confounders in multivariable analysis, a DSI > 31 days (versus ≤ 20 days) retained independent associations with adverse outcomes at 5 years, with hazard ratios of 1.07 for both DSS and OS. Propensity score matching and multivariable analysis comparing DSI ≤ 20 days to DSI > 31 days stratified by pathological stage III-IV showed that higher DSS and OS rates were observed in patients with DSI ≤ 20 days than DSI > 31 days (68 %/66 %, p = 0.0586; 60 %/57 %, p = 0.0228, respectively), with hazard ratios of 1.09 for both DSS and OS.
Our findings indicate that DSI is an independent predictor of 5-year DSS and OS in patients with OCSCC. A DSI exceeding 31 days, or even 21 days, may potentially decrease survival outcomes.
口腔鳞状细胞癌（OCSCC）患者诊断至手术间隔时间（DSI）延长是否会影响生存结果的问题仍未得到解答。这项全国性研究旨在解决这一问题。
我们分析了2011年至2021年台湾癌症登记数据库中确诊的26214例原发性OCSCC患者的数据。使用Cox回归分析，根据5年疾病特异性生存率（DSS）和总生存率（OS）确定最佳DSI临界值。患者被分为三个不同的DSI组：≤20天（47%）、21 - 31天（31%）和>31天（22%）。
≤20天/21 - 31天/>31天组的5年DSS率和OS率分别为81%/78%/77%和73%/70%/68%（p均<0.0001）。≤20天组患者病理分期I - II的患病率较高。在多变量分析中对潜在混杂因素进行调整后，DSI>31天（与≤20天相比）在5年时仍与不良结局存在独立关联，DSS和OS的风险比均为1.07。倾向评分匹配和多变量分析比较了病理分期为III - IV的DSI≤20天与DSI>31天的患者，结果显示DSI≤20天的患者DSS率和OS率高于DSI>31天的患者（分别为68%/66%，p = 0.0586；60%/57%，p = 0.0228），DSS和OS的风险比均为1.09。
我们的研究结果表明，DSI是OCSCC患者5年DSS和OS的独立预测因素。DSI超过31天，甚至21天，可能会降低生存结果。
