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Scientific Oral Presentations

Care Equity, Quality, and Safety

Session: Scientific Oral Presentations 3 - Care Equity, Quality, and Safety

Quality Improvement in Timely Postoperative Radiation Therapy for Oral Cavity Cancer

Monday, October 13, 2025
9:54 AM - 10:00 AM EDT
Location: 107-108
Disclosure(s):
Kasey R. Bowyer, AB:

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

Introduction: Timely adjuvant postoperative radiation therapy (PORT) is crucial for oral cavity cancer outcomes and a key quality indicator in head and neck cancer care. However, many patients do not receive PORT within the optimal time frame, and factors contributing to this delay in large managed healthcare networks remain understudied, presenting opportunities for quality improvement.

Methods: This retrospective chart review analyzed 216 patients aged 18-99 who underwent oral cavity cancer resection and PORT within Kaiser Permanente Southern California (KPSC) from 2015 to 2022. Institutional multidisciplinary consensus guidelines were used to assess predicted PORT time, with generalized linear and logistic regression models identifying risk factors for delays. Preliminary analyses are ongoing.

Results: 216 patients underwent oral cavity cancer resections with PORT during the study period (57.9% male; median [SD] age, 64 [12.2] years, median [SD] PORT time, 8.9 [2.6] weeks). Most had stage IV (52.7%) or stage III (28.7%) cancer, with 49.5% exhibiting perineural invasion and 25.5% with lymphovascular invasion. Higher tumor stage predicted shorter PORT time (P = 0.015), while older age was linked to PORT delays (P = 0.033). Other factors, including adjuvant chemotherapy, free flap reconstruction, and tobacco use, were not significant predictors. In response, a multidisciplinary team has implemented earlier preoperative radiation oncology and dental referrals. Prospective data collection is ongoing.

Conclusions: This study identifies key factors associated with PORT delays, particularly tumor stage and patient age. Insights gained are being applied to improve treatment timelines through workflow changes in multidisciplinary care.

    Presenting Author(s)

  • Kasey R. Bowyer, AB

    MS3
    Kaiser Permanente Bernard J. Tyson School of Medicine
    Pasadena, CA, United States

    Disclosure(s):

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

    • Co-Author(s)

  • AL

    Alice C. Lin, MD

    Partner Physician, Phase 3 Otolaryngology Director
    Kaiser Permanente Southern California
    Los Angeles, CA, United States

    Disclosure information not submitted.

  • OB

    Onita Bhattasali, MD

    Department of Radiation Oncology Kaiser Permanente Los Angeles Medical Center, United States

    Disclosure information not submitted.

  • SI

    Shawn Iganej, MD

    Department of Radiation Oncology Kaiser Permanente Los Angeles Medical Center, United States

    Disclosure information not submitted.

    • Senior Author(s)

  • AL

    Andrew R. Larson, MD

    Head and Neck Oncologic Surgery
    Kaiser Permanente Los Angeles Medical Center
    Los Angeles, CA, United States

    Disclosure information not submitted.