COVID-19 as a Natural Experiment in Virtual Oncology Care and Head and Neck Cancer Outcomes
Asher J. Shin, Ethan D. Shin, Justin Choi, Olivia Cartaño, Yingzhi Wu, Edward C. Dee, Yao Yu, Kaveh Zakeri, Daphna Y. Gelblum, Nadeem Riaz, Eric J. Sherman, David G. Pfister, Richard J. Wong, Jung J. KangObjectives:
Oncology rapidly adopted telemedicine during COVID‑19, with limited outcome data. Prior work from our group reported the feasibility of telehealth consultations for head-and-neck cancer, one of the most challenging subsites to forego face-to-face encounters. Telemedicine remains an important mode of health care delivery, but data are lacking on cancer outcomes with entry into the treatment pathway through virtual versus conventional in-person consultations. We aimed to address the evidence gap by evaluating cancer outcomes in a homogeneous group of patients with oropharyngeal cancer (OPC) who underwent virtual new-patient consultations.
Methods:
Prospective nonrandomized cohort study at a multistate comprehensive cancer center. The telemedicine (TELE) cohort comprised 41 consecutive radiation oncology OPC consultations from 3/2020 to 9/2020; the standard in‑person (STIP) cohort included 104 patients from 10/2019 to 9/2020 with balanced baseline clinicopathologic features. Follow‑up ended May 31, 2025 (median: 57.0 mo). Primary endpoints included 3-year outcomes: locoregional control (LRC), distant metastasis-free survival (DMFS), progression-free survival (PFS), and cancer-specific survival (CSS). The following quality-of-care metrics were evaluated: time to initiation of treatment, clinical trial enrollment, and feeding tube placement.
Results:
There were no differences in 3-year outcomes between TELE and STIP cohorts: LRC (92.3% vs. 97.0%,
Conclusions:
Telemedicine new patient oncology consultations did not compromise OPC outcomes or care quality. These findings from a pandemic-driven natural experiment support virtual oncology consultations as a viable form of patient-centered care and may encourage telemedicine outcomes studies across other specialties.