Impact of time to treatment on overall survival for patients with oropharyngeal squamous cell carcinoma: A SEER database analysis.

Abstract

e13879 Background: Incidence and mortality of oropharyngeal squamous cell carcinoma (OSCC) have continued to rise since the mid 2000s. Few studies have examined the impact of optimal time of treatment initiation (TTI). The aim of this study is to investigate the association between TTI and survival while analyzing socioeconomic factors associated with a delay in treatment. Methods: Patients diagnosed with Oropharyngeal squamous cell carcinoma (OSCC) from the Surveillance, Epidemiology, and End Results (SEER) database between 2000-2021 were selected. Additional variables were collected including age, sex, race, stage, surgical status, radiation status, TTI, household income, and population size. Survival was analyzed via Cox regression analyses. Logistic regression contrasted variables associated with delayed TTI. Results: A total of 37,627 patients were included. On Cox regression, no survival difference was observed between patients with TTI less than one month compared to greater than one month. Patients with median household income of > $50k (p < 0.001, HR = 0.830) and 100k+ (p < 0.001, HR = 0.673), recipients of surgery (p < 0.001, HR = 0.421), chemotherapy (p < 0.001, HR = 0.868) and radiation therapy (p < 0.001, HR = 0.450) were all associated with improved survival. Patients between the ages of 50-64 years (p < 0.001, HR = 1.223) or 65+ (p < 0.001, HR = 1.824), Black (p < 0.001, HR = 1.867) or Hispanic (p < 0.001, HR = 1.248) and with regional (p < 0.001, HR = 1.686) or distant (p < 0.001, HR = 4.400) stages at diagnosis were associated with worse survival. On Logistic regression, patients with median household income of > $50k (p = 0.043, OR = 0.108) or $100k+ (p < 0.001, OR = 1.240), those who lived in metropolitan areas (p < 0.001, OR = 0.849), regional (p = 0.017, OR = 0.896) or distant (p < 0.001, OR = 0.822) stages, recipients of surgery (p < 0.001, OR = 0.206) and chemotherapy (p < 0.001, OR = 0.801) were all associated with earlier TTI. Age 50-64 years (p < 0.001, OR = 1.214) or 65+ (p < 0.001, OR = 1.338) and Hispanic (p < 0.001, OR = 1.354) or Black (p < 0.001, OR = 1.345) populations were associated with later TTI. Conclusions: There were no significant survival differences between TTI within or more than 1 month; however, demographic factors associated with decreased TTI were also associated with better survival outcomes. Increased age and black and hispanic race are associated with worse survival. Future research should focus on addressing disparities in survival and TTI between populations.