Sluis, Gijs van der (2024) Determinants of Waiting Times in the Care Pathway of Nasopharyngeal Carcinoma in a Non-endemic Region: A Retrospective Cohort Study. thesis, Medicine.
Full text available on request.Abstract
Background and aim: Treatment delay of patients with head and neck cancer is associated with worse survival rates. Literature on the determinants influencing time intervals in the care pathway of patients with nasopharyngeal carcinoma (NPC) is scarce. The aim of this study was to examine the association between patient, tumor and treatment characteristics and time intervals in NPC patients treated with proton therapy in a non-endemic area. Methods: This retrospective cohort study included patients with histologically confirmed NPC treated at a head and neck oncology center (HNOC) with proton facility. Patient, tumor, diagnostic, treatment and care pathway characteristics were extracted from electronic health records. The primary outcome measures were the Time-to-treatment interval (TTI, histopathological diagnosis tot treatment start) and the care-pathway interval (CPI, first visit to treatment start). Logistic, linear, and Cox regression analyses were performed for statistical analysis. Results: In multivariable linear regression, patients with a TNM stage determined before referral had a significantly shorter TTI. Higher TNM stage, referrals from other HNOCs, and a cytological puncture during the diagnostic process were borderline significantly associated with a longer TTI (cytological puncture with a shorter TTI). In multivariable logistic regression analysis, imaging performed externally (PET-CT or MRI) and HNOC referrals were significantly associated with a shorter CPI. Tooth extraction prior to treatment initiation was borderline significantly associated with a shorter CPI. Conclusion: This study found that a TNM stage determined at the referral site was associated with a shorter TTI. The CPI was influenced by the TNM stage, the number of diagnostics and work-up done externally.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Halmos, dr. G.B. and Schoonbeek, dr. R.C. |
| Faculty: | Medical Sciences |
| Date Deposited: | 17 Jan 2025 12:34 |
| Last Modified: | 17 Jan 2025 12:34 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3789 |
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