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Scientific Oral Presentations

Head and Neck Surgery

Session: Scientific Presentation 8 - Head and Neck Surgery

Factors Associated with Time to Post-Operative Radiation Therapy in Veterans with Head and Neck Cancer

Tuesday, October 14, 2025
8:12 AM - 8:18 AM EDT
Location: 128
Disclosure(s):
Allison C. Rollins, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Matthew E. Spector, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Jessica H. Maxwell, MD, MPH:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Initiation of post-operative radiation therapy (PORT) within six weeks of surgery for head and neck squamous cell carcinoma (HNSCC) is a National Comprehensive Cancer Network (NCCN) guideline and quality metric. The rate of guideline concordance in the Veteran population remains unknown. Our objective was to assess time to PORT among Veterans with HNSCC and its impact on overall survival (OS).

Methods: Patients diagnosed with HNSCC from 2012-2022, identified from the National Veteran’s Affairs Database, were included. Treatment received (surgery/radiation therapy), demographics (age, gender, race/ethnicity, marital status), tobacco/alcohol use, area deprivation index (ADI), Elixhauser score, body mass index (BMI), rurality measured by Rural Urban Continuum Codes and distance from treating VA were extracted. Analyses conducted were bivariate comparisons via chi-square and Wilcoxon rank sums test and adjusted multivariate linear regression modeling to assess subsite differences.

Results: Among 2,719 HNSCC Veterans who received surgery and adjuvant radiation, 1638 (60.2%) received PORT within 6 weeks of surgery. Average time to PORT was 43.89 days for oral cavity patients (n=794), 42.87 for larynx (n=926), 42.59 for oropharynx (n=905), 42.07 for hypopharynx (n=74) and 31.2 for nasopharynx (n=20; p<.001 when compared to nasopharynx). Factors were concurrently modeled to measure associations with delayed time to PORT, including age, race, gender, tobacco/alcohol use, ADI, BMI, marital status, Elixhauser score, rurality, driving distance and subsite. Being unmarried (p=0.03) and having oral cavity cancer (p < 0.001) were significantly associated with a greater than 6-week time to PORT. Three-year OS was higher among those who received PORT within 6 weeks (70.2%) compared to those who received PORT greater than 6 weeks post-operatively (62.1%, p<.001).

Conclusions: Veterans with HNSCC receive guideline concordant PORT at a rate of 60.2% with a significantly improved OS for patients receiving guideline concordant PORT. Being unmarried and having oral cavity cancer were associated with delays in PORT.

    Presenting Author(s)

  • Allison C. Rollins, MD

    Otolaryngology Resident
    University of Pittsburgh, Department of Otolaryngology/Head and Neck Surgery
    Pittsburgh, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • MB

    Monique Boudreaux-Kelly, PhD

    Office of Research and Development, Veteran’s Affairs Pittsburgh Healthcare System, United States

    Disclosure information not submitted.

  • Jennifer L. McCoy, MA

    Senior Research Associate, Pediatric Otolaryngology
    UPMC Children’s Hospital of Pittsburgh
    Pittsburgh, Pennsylvania, United States

    Disclosure information not submitted.

  • Matthew E. Spector, MD

    Professor
    Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh
    Pittsburgh, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Chad J. Brenner, PhD

    Associate Professor
    University of Michigan
    Ann Arbor, MI, United States

    Disclosure information not submitted.

  • Marci L. Nilsen, PhD, RN, CHPN, FAAN

    Professor
    University of Pittsburgh Department of Otolaryngology-Head & Neck Surgery
    Pittsburgh, Pennsylvania, United States

    Disclosure information not submitted.

  • AM

    Angela L. Mazul, PhD

    Assistant Professor
    University of Pittsburgh
    Pittsburgh, PA, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • JM

    Jessica H. Maxwell, MD, MPH

    Associate Professor
    Department of Otolaryngology-Head & Neck Surgery, University of Pittsburgh Medical Center
    Pittsburgh, PA, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.