Association between Treatment Delays and Survival of Nasopharyngeal Carcinoma Patients: Analysis from a Nationwide Representative Cohort study in US population

Abstract Background Treatment delays have frequently been observed in cancer patients. Whether the treatment delays would impair the survival of patients with nasopharyngeal carcinoma (NPC) is still unclear. Methods The data was derived from the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2015. Patients were divided into groups of timely treatment (< 1 month), intermediate delay (1–2 months), and long delay (3–6 months). The influence of different treatment delay intervals on long-term survival was evaluated by multivariate Cox regression analysis. Results Generally, there were 2,048 NPC patients from the SEER database finally included in this study. There were 551 patients in the early stage (I, II stage: 26.9%) and 1,497 patients in the advanced stage (III, IV stage: 73.1%). No significant difference in overall survival (OS) or cancer-specific survival (CSS) was observed among the three groups, regardless of the stage (p = 0.48 in OS and p = 0.43 in CSS, respectively). However, after adjusting the covariates, a significantly better OS probability were observed in intermediate treatment delay patients compared with timely treatment groups in the whole stage (adjustedHazard ratio (aHR) = 0.86, 95%CI: 0.74–0.99, p = 0.043) and in advanced stage (aHR = 0.85, 95%CI: 0.72-1.00, p = 0.049) NPC patients. Similar results were also observed in the CSS (aHR = 0.84, 95%CI: 0.71–0.98, p = 0.030 in whole stage patients and aHR = 0.83, 95%CI: 0.70–0.99, p = 0.038 in advanced stage patients). Conclusions Our results revealed that treatment delays might not impair the survival of NPC patients. Whether intermediate treatment delays could improve the clinical outcomes of NPC patients need further validation.