Survival (Time-To-Event) Curve Names and Endpoints.

In oncology, "survival curves" frequently appear in journal articles and meeting presentations. The most common labels on survival curves are overall survival, relapse-free survival, progression-free survival, distant metastasis-free survival, and local and/or regional control. Unfortunately, consistency in the definition of an event differs between authors for the same prescribed survival analyses. Furthermore, the quality of survival curves can be greatly impacted by the methodology used for endpoint selection. This paper will briefly explain widely used names and event endpoints for survival analyses in a way that will help radiation oncologists consistently present and interpret experimental findings that influence clinical practice decisions.

Flap Reconstruction Results in Longer Overall Treatment Time in Patients Treated With Surgery and Adjuvant Radiotherapy for Carcinoma of the Oral Cavity and Larynx.

OBJECTIVE: There is an inverse relationship between cancer cure and overall treatment time (OTT) in patients treated with surgical resection and radiotherapy (RT). METHODS: OTT was evaluated based on the reconstruction procedure in 420 patients with oral cavity and larynx cancers treated with surgery and RT between 1991 and 2020. RESULTS: With OTT >85 days, the difference between no versus yes flap reconstruction was ~20 percentage points and significant for all comparisons: primary closure (+/- skin graft), 49%, vs. rotation or free flap, 71% ( P <0.0001); primary closure (+/- skin graft), 49%, versus free flap without bone, 66% ( P =0.0358); and primary closure (+/- skin graft), 49%, versus free flap with bone, 82% ( P <0.0001). CONCLUSIONS: The use of flap reconstructions results in substantial increases in OTT. Findings suggest a need to reevaluate current policies regarding the choice of reconstruction and starting RT sooner after surgery.