Table 1.
Demographic, Oncologic, and Treatment Characteristics and Their Association With Delayed PORTa
| Variable | Treatment Group | OR (95% CI) | ||
|---|---|---|---|---|
| All (N = 197) | Delayed PORT (n = 89) | Timely PORT (n = 108) | ||
| Age, mean (range), y | 59 (28-89) | 59 (33-89) | 59 (28-88) | 1.01 (0.98-1.03) |
| Sex, No. (%) | ||||
| Female | 61 (31.0) | 28 (31.5) | 33 (30.6) | 1 [Reference] |
| Male | 136 (69.0) | 61 (68.5) | 75 (69.4) | 0.96 (0.52-1.76) |
| Race, No. (%) | ||||
| White | 157 (79.7) | 68 (76.4) | 89 (82.4) | 1 [Reference] |
| African American | 37 (18.8) | 21 (23.6) | 16 (14.8) | 1.71 (0.84-3.58) |
| Other | 3 (1.5) | 0 | 3 (2.8) | NA |
| Insurance, No. (%)b | ||||
| Private or Medicare | 158 (81.0) | 68 (77.3) | 90 (84.1) | 1 [Reference] |
| Medicaid or self-pay | 37 (19.0) | 20 (22.7) | 17 (15.9) | 1.56 (0.76-3.23) |
| Relationship status, No. (%) | ||||
| Married | 125 (63.4) | 50 (56.2) | 75 (69.4) | 1 [Reference] |
| Not married | 72 (36.5) | 39 (43.8) | 33 (30.6) | 1.77 (0.99-3.20) |
| Travel distance, miles, No. (%) | ||||
| <50.0 | 45 (22.8) | 14 (15.7) | 31 (28.7) | 1 [Reference] |
| 50.0-99.9 | 46 (23.4) | 20 (22.5) | 26 (24.1) | 1.70 (0.73-4.08) |
| >100.0 | 106 (53.8) | 55 (61.8) | 51 (47.2) | 2.39 (1.16-5.11) |
| ACE-27 score, No. (%)c | ||||
| 0-1 | 149 (75.6) | 66 (74.2) | 83 (76.8) | 1 [Reference] |
| 2-3 | 48 (24.5) | 23 (25.8) | 25 (23.1) | 1.16 (0.60-2.23) |
| Prior treatment, No. (%) | ||||
| None | 143 (72.6) | 61 (68.5) | 82 (75.9) | 1 [Reference] |
| Surgery (only) | 29 (14.7) | 15 (16.9) | 14 (13.0) | 1.44 (0.65-3.24) |
| Surgery plus adjuvant therapy | 9 (4.6) | 5 (5.6) | 4 (3.7) | 1.69 (0.43-7.04) |
| Primary RT or CRT | 16 (8.1) | 8 (9.0) | 8 (7.4) | 1.34 (0.47-3.85) |
| Prior HNSCC, No. (%) | ||||
| No | 143 (72.6) | 61 (68.5) | 82 (75.9) | 1 [Reference] |
| Yes | 54 (27.4) | 28 (31.5) | 26 (24.1) | 1.45 (0.77-2.72) |
| Length of stay, d, No. (%) | ||||
| ≤7 | 80 (40.6) | 31 (34.8) | 49 (45.4) | 1 [Reference] |
| 8-14 | 74 (37.6) | 34 (38.3) | 40 (37.0) | 1.34 (0.71-2.56) |
| ≥15 | 43 (21.8) | 24 (27.0) | 19 (17.6) | 2.00 (0.95-4.28) |
| Discharge destination, No. (%) | ||||
| Home without home health referral | 67 (34.0) | 26 (29.2) | 41 (38.0) | 1 [Reference] |
| Home with home health referral | 108 (54.8) | 53 (59.6) | 55 (50.9) | 1.52 (0.82-2.84) |
| Skilled nursing facility | 20 (10.2) | 10 (11.2) | 10 (9.3) | 1.58 (0.57-4.36) |
| Other | 2 (1.0) | 0 | 2 (1.8) | NA |
| HNSCC subsite, No. (%) | ||||
| Oral cavity | 120 (60.9) | 58 (65.2) | 62 (57.4) | 1 [Reference] |
| Oropharynx | 42 (21.3) | 16 (18.0) | 26 (24.1) | 0.66 (0.32-1.34) |
| Hypopharynx | 10 (5.1) | 6 (6.7) | 4 (3.7) | 1.60 (0.44-6.54) |
| Larynx | 25 (12.7) | 9 (10.1) | 16 (14.8) | 0.60 (0.24-1.44) |
| Pathologic T classification, No. (%) | ||||
| 0-2 | 67 (34) | 27 (30.3) | 40 (37.0) | 1 [Reference] |
| 3-4 | 130 (66.0) | 62 (69.7) | 68 (63.0) | 1.35 (0.75-2.47) |
| Pathologic N classification, No. (%) | ||||
| 0-1 | 109 (55.3) | 47 (52.8) | 62 (57.4) | 1 [Reference] |
| 2-3 | 88 (44.7) | 42 (47.2) | 46 (42.6) | 1.20 (0.68-2.12) |
| Extracapsular spread, No. (%) | ||||
| No | 124 (62.9) | 56 (62.9) | 68 (63.0) | 1 [Reference] |
| Yes | 73 (37.1) | 33 (37.1) | 40 (37.0) | 1.00 (0.56-1.79) |
| Surgical margins, No. (%) | ||||
| Negative | 176 (89.3) | 81 (91.0) | 95 (88.0) | 1 [Reference] |
| Positive | 21 (10.7) | 8 (9.0) | 13 (12.0) | 0.72 (0.27-1.80) |
| Reconstruction, No. (%) | ||||
| None | 54 (27.4) | 20 (22.5) | 34 (31.5) | 1 [Reference] |
| Allograft/skin graft | 13 (6.6) | 8 (9.0) | 5 (4.6) | 2.72 (0.79-10.10) |
| Regional flap | 9 (4.6) | 4 (4.5) | 5 (4.6) | 1.36 (0.31-5.73) |
| Free flap | 121 (61.4) | 57 (64.0) | 64 (59.3) | 1.51 (0.79-2.96) |
| Adjuvant therapy, No. (%) | ||||
| RT | 94 (47.7) | 36 (40.4) | 58 (53.7) | 1 [Reference] |
| CRT | 103 (52.3) | 53 (59.6) | 50 (46.3) | 1.71 (0.97-3.03) |
| Postoperative wound complication, No. (%) | ||||
| No | 162 (82.2) | 66 (74.2) | 96 (88.9) | 1 [Reference] |
| Yes | 35 (17.8) | 23 (25.8) | 12 (11.1) | 2.79 (1.32-6.16) |
| Postoperative wound complication, No. (%) | ||||
| None | 162 (82.2) | 66 (74.2) | 96 (88.9) | 1 [Reference] |
| Inpatient | 19 (9.6) | 12 (13.5) | 7 (6.5) | 2.49 (0.95-7.01) |
| Outpatient | 16 (8.1) | 11 (12.4) | 5 (4.6) | 3.20 (1.11-10.55) |
| 30-Day readmission, No. (%) | ||||
| No | 180 (91.4) | 81 (91.0) | 99 (91.7) | 1 [Reference] |
| Yes | 17 (8.6) | 8 (9.0) | 9 (8.3) | 1.08 (0.39-2.94) |
| Postdischarge unplanned reoperation before RT, No. (%) | ||||
| No | 187 (94.9) | 81 (91.0) | 106 (98.1) | 1 [Reference] |
| Yes | 10 (5.1) | 8 (9.0) | 2 (1.8) | 5.23 (1.27-35.31) |
Abbreviations: ACE-27, Adult Comorbidity Evaluation-27; CRT, chemoradiotherapy; HNSCC, head and neck squamous cell carcinoma; NA, not applicable; OR, odds ratio; PORT, postoperative radiotherapy; RT, radiotherapy.
SI conversion factor: To convert miles to kilometers, multiply by 1.6.
a
Percentages have been rounded and may not total 100. Delayed PORT indicates more than 42 days after surgery.
b
Two patients had other insurance.
c
Higher scores indicate greater severity.