Analysis of critical times in diagnosis and treatment of Head and Neck Cancer at Hospital Sótero del Río

Abstract

Introduction: Head and neck cancer (H&NCa) represents a high burden of disease. Delay in starting treatment is an independent predictor of mortality. Objective: To describe the ti­mes between the key diagnostic and therapeutic milestones of patients with H&NCa treated at the Hospital Sótero del Río (CASR) and compare the local experience with internatio­nal guidelines. Material and Method: descriptive-retrospective study of patients presented to the Head and Neck Oncology Committee (H&NOCO) of the CASR from September 2020 to July 2022. The critical times of the diagnostic and therapeutic process are analyzed. Results: 78 patients are selected, 75.5% with squamous cell carcinoma. The median time between referral from primary care (PC) and CASR evaluation is 2 days, between evalua­tion and biopsy is 9 days, and between histological diagnosis and initiation of treatment in any modality is 27 days. Critical times are compared according to the deadlines defined by Cancer Council Australia. Compliance rates between PC referral and CASR admission is 67%. Depending on the treatment received, the compliance rate from admission to the start of treatment is 70% for exclusive surgery, 0% for the start of radiotherapy, and 20% for ra­diochemotherapy. For surgery and adjuvant radiotherapy, the rate is 67% between evalua­tion and surgery, and 6% between surgery and radiotherapy. Conclusion: Waiting times between key diagnostic and therapeutic process are described. The times of referral from PC and start of surgical therapies are comparable to the international literature. However, times regarding the start radiotherapy can be improved.