ArticleClinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico2026
Impact of fast-track pathway implementation on time to diagnosis, stage at diagnosis, and overall survival in head and neck cancer.
Article in Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo evaluate the association between the operational implementation of a Fast-Track referral pathway for head and neck cancer and changes in care intervals, tumor profile at diagnosis, and overall survival in a real-world tertiary care cohort. PATIENTS AND
methodsRetrospective observational historical cohort study including patients with a primary malignant ENT tumor treated between January 2010 and August 2023. Patients were classified according to diagnostic period as Pre-Fast-Track or Post-Fast-Track, using January 2018 as the operational implementation date. Care intervals, tumor characteristics, route of entry into the pathway, and overall survival were analyzed.
resultsA total of 1106 patients were included: 614 in the Pre-Fast-Track period and 492 in the Post-Fast-Track period. After implementation, median referral time decreased from 9 to 5 days, first ENT consultation-to-treatment time from 27 to 21 days, and referral-to-treatment time from 50 to 43 days, all p < 0.001. The Post-Fast-Track period also showed a lower proportion of stage III-IV disease. Among post-implementation patients with available data, 22.8% entered through the Fast-Track pathway. Kaplan-Meier curves showed no significant survival differences between periods (log-rank, p = 0.95). In the multivariable Cox model, the Post-Fast-Track period was not independently associated with overall survival (adjusted HR 0.94; 95%CI 0.77-1.15; p = 0.537).
conclusionsThe operational implementation of a Fast-Track pathway was associated with shorter care intervals and a relatively less advanced-stage distribution at diagnosis, but not with improved overall survival. Its clinical impact may depend on pathway penetration and the efficiency of the entire diagnostic-therapeutic process.
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