Influence of time delay and clinical upstaging in the prognosis of head and neck cancer

The delayed time period between the first diagnosis of a head and neck canc er and its treatment can affect not only the clinical staging of the diseas e, but also its prognosis. The time period for clinical upstaging is studie d in a retrospective cohort series. A retrospective case/control series was established to assess the prognosis of head and neck cancer patients due t o a delay in treatment. In the first part of the study we included 69 patie nts who had confirmed clinical upstage before starting the oncologic treatm ent (cases). The survival of this series was compared to a historical contr ol group of 138 patients matched by tumour site and stage, having received treatment within a short period after their first medical evaluation (contr ols). We observed that the natural evolution of a head and neck cancer was progressively faster, From an initial clinical stage to an advanced clinica l stage until it becomes untreatable. it was observed that the delay in beg inning oncologic treatment influenced the prognosis of the patients (P = 0. 030), especially in clinical stage TV patients (P = 0.001) and oral cavity cancer patients (P = 0.007). (C) 2001 Elsevier Science Ltd. All rights rese rved.