Examination of care processes and treatment optimization for head and neck cancer patients in a community setting "hub and hub" model.
Harleen K Sethi, Elijah Walker, Travis Weinsheim, Matthew J Brennan, Christopher E Fundakowski
Author Information
Harleen K Sethi: Department of Otolaryngology-Head and Neck Surgery Sidney Kimmel Cancer Center at Abington-Jefferson Health Willow Grove Pennsylvania USA.
Elijah Walker: College of Applied Health Science, University of Illinois at Urbana-Champaign Urbana Illinois USA.
Travis Weinsheim: Department of Otolaryngology-Head and Neck Surgery Sidney Kimmel Cancer Center at Abington-Jefferson Health Willow Grove Pennsylvania USA.
Matthew J Brennan: Department of Otolaryngology-Head and Neck Surgery Sidney Kimmel Cancer Center at Abington-Jefferson Health Willow Grove Pennsylvania USA.
Christopher E Fundakowski: Department of Otolaryngology-Head and Neck Surgery Sidney Kimmel Cancer Center at Abington-Jefferson Health Willow Grove Pennsylvania USA.
Objective: To examine referral pattern, the timing of diagnostic/staging processes, and treatment initiation for new head and neck cancer patients in a community setting. Methods: Patients with a newly diagnosed previously untreated diagnosis of head neck cancer managed at Asplundh Cancer Pavilion/Abington Memorial Hospital from October 2018 to March 2020. Source of referral and preceding workup were examined as well as intervals between initial head and neck consult and various timepoints of treatment initiation. Results: One hundred and five patients were included in the study. The primary referral sources were external general otolaryngology (56.3%). Oral surgery and dermatology obtained tissue biopsy approximately 80% of the time before referral. The average time from the ordering of initial staging positron emission tomography/computed tomography to finalized results was 14 days (range: 10-25 days). Patients referred from dermatology and oral surgery were more likely to require single modality care, namely definitive surgical management. Time to treatment initiation average was 37 days (range: 29-41 days). Patients with longer treatment times noted significantly higher times to both radiation and medical oncology consults (48.42 vs. 18.13 days; ���<���0.001). Conclusions: No notable differences in treatment initiation times were identified based on referral source or extent of workup performed before head/neck surgery consult. It appears the largest opportunities for improvement in terms of reducing overall treatment length exist in the optimization of radiation initiation time.
