Factors Contributing to Late Cancellation and No-Show for Otolaryngologic Surgery: A Prospective Study.

PURPOSE: Late cancellations and no-shows for surgery place a burden on patients, healthcare providers, and the health system. We aim to identify risk factors contributing to this phenomenon. METHODS: Patients who did not arrive for, or canceled within 24 hours of, their surgical appointment between January 2019 and 2020 were identified. Controls were matched by date, procedure, and gender. Demographic information was obtained by phone interview and chart review. Chi-square and Student t-test analyses were used to predict risk factors for cancellation. RESULTS: Thirty-one patients were identified, of whom 21 completed phone interviews. Age, gender, race, language, marital status, and smoking status were not significantly different. Study patients reported more transportation challenges (33.3% vs. 4.8%, p = .01) yet lived closer to the hospital (4.53 miles vs. 14.05 miles, p = .01). Study patients lived in lower income zip codes ($48,145 vs. $63,406, p = .02) and more commonly had Medicaid as their primary insurance (70.9% vs. 38.7%, p = .04). Most commonly, no reason was given for cancellation (22.6%) followed by personal reasons (16.1%) and surgery reconsideration (16.1%). CONCLUSIONS: Transportation trouble and lower income are significant risk factors for surgery late cancellation. Prior no-show must also be considered. A targeted pilot program may help prevent late cancellations.

Effect of HPV Status on Survival of Oropharynx Cancer with Distant Metastasis.

Human papillomavirus (HPV)-positive oropharynx squamous cell carcinoma (OPSCC) is known to have improved survival over HPV-negative disease. However, it is largely unknown whether HPV status similarly affects survival in patients presenting with distant metastatic disease. We queried the National Cancer Database for OPSCC with distant metastasis. Kaplan-Meier curves and Cox proportional hazards regression models controlling for relevant demographics were used to evaluate overall survival. In total, 768 OPSCC cases were available for analysis with HPV and survival data: 50% of cases were HPV negative and 50% were HPV positive. The 1- and 2-year survival for HPV-negative disease was 49% and 27%, respectively, as compared with 67% and 42% in the HPV-positive cohort. HPV positivity was associated with improved median survival in treated and untreated patients. Age, comorbidities, and HPV status were predictive of improved survival on multivariate analysis. HPV-positive OPSCC has improved survival in the setting of distant metastatic presentation as compared with HPV-negative disease and shows greater responsiveness to treatment.