The impact of compliance in posttreatment surveillance in head and neck squamous cell carcinoma
| Autor: | John Harbison, Michael W. Deutschmann, Yelizaveta Shnayder, Kevin J. Sykes, Cristina Cabrera-Muffly |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Disease-Free Survival Cohort Studies Young Adult Internal medicine Medicine Humans Survival rate Survival analysis Aged Neoplasm Staging Proportional Hazards Models Retrospective Studies Aged 80 and over business.industry Proportional hazards model Hazard ratio Head and neck cancer Retrospective cohort study Continuity of Patient Care Middle Aged medicine.disease Prognosis Head and neck squamous-cell carcinoma Survival Analysis Surgery Survival Rate Otorhinolaryngology Withholding Treatment Head and Neck Neoplasms Health Care Surveys Carcinoma Squamous Cell Patient Compliance Female Smoking Cessation business Cohort study Follow-Up Studies |
| Zdroj: | JAMA otolaryngology-- headneck surgery. 141(6) |
| ISSN: | 2168-619X |
| Popis: | Importance Posttreatment surveillance (PTS) is a key component in the treatment of patients with head and neck cancer. It is unclear how beneficial this is in improving patients’ survival. Objective To determine how compliance with follow-up affects clinical outcomes in patients with head and neck squamous cell carcinoma. Design, Setting, and Participants This was a retrospective cohort study at a tertiary academic center of a total of 332 patients with head and neck squamous cell carcinoma who had completed both treatment and follow-up at the University of Kansas Medical Center. Patient and tumor characteristics, socioeconomic status, and geographic data were collected. Exposures Compliance with PTS. Main Outcomes and Measures The effect of compliance with PTS on overall survival. Results Compliance with PTS, US Census tract income level, and the distance patients travel for follow-up had significant effects on survival ( P = .001, P = .001, and P = .01, respectively). Cox proportional hazard models revealed that more advanced disease (hazard ratio [HR], 1.76 [95% CI, 1.21-2.58]; P = .003), middle (HR, 1.64 [95% CI, 1.13-2.39]; P = .009) and moderate (HR, 1.90 [95% CI, 1.18-3.06]; P = .008) census tract income level, and age (HR, 1.03 [95% CI, 1.01-1.04]; P P = .003), as well as the distance a patient lived from the medical center ( P = .008). Conclusions and Relevance Patients with head and neck squamous cell carcinoma were significantly more likely to survive with completion of follow-up and tobacco cessation. Compliance with PTS was associated with smoking cessation and traveling less than 200 miles for follow-up. |
| Databáze: | OpenAIRE |
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