{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T11:00:58Z","timestamp":1789988458248,"version":"4.0.1"},"reference-count":32,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Postoperative radiotherapy (PORT) improves locoregional control and survival in high\u2010risk head and neck cancer, and guidelines recommend initiation within 42\u2009days of surgery. Timeliness after laryngectomy for pathologic T4 (pT4) laryngeal cancer is poorly characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a retrospective National Cancer Database cohort of adults with nonmetastatic pT4 laryngeal squamous cell carcinoma undergoing total laryngectomy (2010\u20132022), multivariable logistic regression identified predictors of delayed (43\u2013180\u2009days post\u2010operative receipt) and omitted PORT, and a 90\u2010day landmark Cox model evaluated overall survival based on surgery\u2010to\u2010PORT interval.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 6079 patients, 21.2% received timely PORT, 66.2% delayed, and 12.6% omitted within 180\u2009days. Each additional week of delay carried a 3.7% higher adjusted mortality risk. Delay was associated with receipt of radiation at a facility other than the operating institution. Node\u2010positive disease was associated with higher odds of delay but lower odds of omission.\u00a0Omission was also associated with older age, greater comorbidity, and lower neighborhood income.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Timely PORT after laryngectomy is rare; delays and omissions are associated with distinct factors that may benefit from specific interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.70482","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T10:06:42Z","timestamp":1789985202000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Predictors of Delayed and Omitted Postoperative Radiotherapy After Laryngectomy for\n                    <scp>pT4<\/scp>\n                    Laryngeal Cancer"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-1552-1445","authenticated-orcid":false,"given":"George","family":"Ashji","sequence":"first","affiliation":[{"name":"Rutgers New Jersey Medical School  Newark New Jersey USA"},{"name":"Department of Radiation Oncology Memorial Sloan Kettering Cancer Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arun","family":"Rajan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Memorial Sloan Kettering Cancer Center  New York New York USA"},{"name":"John Sealy School of Medicine at the University of Texas Medical Branch  Galveston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elias","family":"Dahl","sequence":"additional","affiliation":[{"name":"University of Rochester  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6783-7983","authenticated-orcid":false,"given":"Sudarshan","family":"Ramanan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Memorial Sloan Kettering Cancer Center  New York New York USA"},{"name":"Sidney Kimmel Medical College, Thomas Jefferson University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3979-4329","authenticated-orcid":false,"given":"Nishant","family":"Chadha","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Memorial Sloan Kettering Cancer Center  New York New York USA"},{"name":"Weill Cornell Medical College  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingzhi","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Memorial Sloan Kettering Cancer Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6259-7314","authenticated-orcid":false,"given":"Richard J.","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Surgery, Head and Neck Service Memorial Sloan Kettering Cancer Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6104-7967","authenticated-orcid":false,"given":"Marc A.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Surgery, Head and Neck Service Memorial Sloan Kettering Cancer Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6119-0889","authenticated-orcid":false,"given":"Edward Christopher","family":"Dee","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Memorial Sloan Kettering Cancer Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy Y.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Memorial Sloan Kettering Cancer Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032646"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032641"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0360\u20103016(01)01690\u2010X"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.30939"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2018.2716"},{"key":"e_1_2_11_7_1","unstructured":"A.WebmasterandAmerican College of Surgeons (ACS)\/Commission on Cancer (CoC)\u2014Approved Quality Metric for HNC \u201cAmerican Head & Neck 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