The effect of time between diagnosis and initiation of treatment on outcomes in patients with head and neck squamous cell carcinoma

•Length of time before treatment may not impact survival in head and neck patients.•May alleviate patient anxiety.•Pre-treatment time can be allocated for useful interventions. To quantify the effect that time to initiation of treatment after diagnosis has on the outcomes of patients with head and neck squamous cell carcinoma (HNSCC). This is a single institution retrospective analysis of 633 HNSCC patients treated from 2004 to 2017. Clinical information was abstracted from the medical records. Patients were divided into quartiles based on the time to treatment initiation (0–27 days, 28–41 days, 42–60 days, and >60 days). Kaplan-Meier overall survival (OS) curves and multivariate cox proportional hazard ratios were determined for time to treatment quartiles. Differences in Kaplan-Meier estimates for OS based on treatment time quartiles were statistically significantly (p = 0.02), and multivariate Cox Proportional hazard ratios for OS revealed that patients in the 42–60 day treatment time group had better OS (hazard ratio = 0.55) compared to patients treated >days after diagnosis (p