Treatment Delays Linked To High Mortality for Head and Neck Cancer Interview with:

Dr. Evan M. Graboyes is a otolaryngologist-head and neck surgeon with the Medical University of South Carolina. CREDIT Emma Vought, Medical University of South Carolina

Dr. Graboyes

Dr. Evan M. Graboyes MD
Otolaryngologist: Head and Neck Surgeon
Medical University of South Carolina What is the background for this study?

Response: Unfortunately, there is no screening test for head and neck cancer like there is for colorectal, prostate, breast, lung, or cervical cancers. As a result, two-thirds of patients with head and neck cancer (HNC) present with loco-regionally advanced disease, making other aspects of timely treatment that much more critically important. We therefore sought to understand the association between treatment delay at different points along the cancer care continuum and oncologic outcomes for patients with head and neck cancer. What are the main findings? 

Response: The main findings of the study are: treatment delays across the cancer care continuum, from diagnosis to treatment initiation, surgery to the start of postoperative radiotherapy (S-PORT), and treatment package time (TPT; surgery through the completion of postoperative radiation), are all associated with poorer survival for patients with head and neck cancer. What should readers take away from your report?

Response: Treatment delays are key contributors to high rates of mortality for patients with head and neck cancer and thus represent an appealing target for directed interventions that can be used to improve patient outcomes. What recommendations do you have for future research as a result of this work? 

Response: While we know that preventing delays in the delivery of head and neck cancer care is a key component of improving outcomes for these patients, we are really just beginning to understand the barriers at the patient, provider, and healthcare system level. Once we understand the barriers that cause delays at each level of healthcare delivery, we can design targeted, multi-level, patient-centered interventions to address them.  Further research is required to standardize optimal time goals, identify barriers to timely care for each treatment interval, and design interventions to minimize delays. Is there anything else you would like to add?

Response: Just as some scientists work to understand cancer genetics, tumor biology, or the immune system in the hope of finding targets that can be modified with a new drug, we see care delivery pathways in the same light. The method of head and neck cancer care delivery is potentially modifiable through targeted interventions and thus represents an important target that can be manipulated to improve survival for head and neck cancer patients.

Dr. Graboyes’’ research is supported by the National Cancer Institute and Hollings Cancer Center through grant 2K12CA157688-6


Graboyes EM, Kompelli AR, Neskey DM, et al. Association of Treatment Delays With Survival for Patients With Head and Neck CancerA Systematic Review. JAMA Otolaryngol Head Neck Surg. Published online November 01, 2018. doi:10.1001/jamaoto.2018.2716

Nov 6, 2018 @ 8:30 pm

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