Delayed Presentation and Its Impact on Outcome in Head and Neck Squamous Cell Carcinoma

Open Access

Abstract

Background: Head and neck squamous cell Carcinoma (HNSCC) pose a significant global health burden, with diverse risk factors and tumor sites complicating management. Delayed presentation often results in advanced-stage disease, necessitating more aggressive treatment and contributing to higher recurrence and mortality, highlighting the importance of assessing its impact on tumor stage, treatment modalities, and clinical outcomes. Objective: To assess the impact of delayed presentation on tumor stage, treatment, and outcomes in patients with head and neck squamous cell Carcinoma. Methods & Materials: A prospective study was conducted at the Department of Otolaryngology–Head & Neck Surgery, Bangladesh Medical University, Dhaka, Bangladesh, from January 2025 to December 2025, including 120 patients with histopathologically confirmed head and neck squamous cell carcinoma. Data on demographics, tumor site and stage, delay before presentation, treatment, and outcomes were collected. Statistical analysis was performed using IBM SPSS Statistics 26 with descriptive statistics and chi-square tests (p < 0.05). Results: Mean age was 52.5 ± 11.7 years; 68.3% were male and 58.3% from rural areas. Larynx (37.5%) and oral cavity (29.2%) were most common. Advanced-stage disease (III–IV) was seen in 65.0%, increasing with delay: 45.0% (<3 months), 66.7% (3–6 months), 85.7% (>6 months) (p < 0.001). Surgery ± adjuvant therapy was most frequent (50.0%). Recurrence and mortality rose with delay: 15.0%, 26.7%, 42.9% and 10.0%, 17.8%, 34.3% (p = 0.006, 0.008). Conclusion: Delayed presentation is strongly linked to advanced-stage disease, higher recurrence, and mortality, highlighting the need for early detection and timely treatment..