BACKGROUND: Because of the relative rarity of head and neck malignancies and their complex treatment, some groups have advocated for regionalized care. Studies comparing high- and low-volume centers have demonstrated mixed results. METHODS: We conducted a systematic review using MEDLINE and EMBASE including all studies examining a volume-outcome relationship in the treatment of patients with head and neck cancer with meta-analysis for long-term survival results. RESULTS: Seventeen studies were identified. Meta-analysis was performed for studies that assessed long-term survival. High-volume hospitals (5 studies; hazard ratio [HR], 0.886; 95% confidence interval [CI], 0.820-0.956) and high-volume surgeons (2 studies; HR, 0.767; 95% CI, 0.641-0.919) have better overall survival than low-volume hospitals and surgeons, respectively. CONCLUSION: Volume-outcome associations exist for head and neck oncologic procedures, although this has not been fully investigated for salivary gland malignancies. Future quality of care studies in head and neck oncology should focus on processes of care, which may explain this relationship.
BACKGROUND: Because of the relative rarity of head and neck malignancies and their complex treatment, some groups have advocated for regionalized care. Studies comparing high- and low-volume centers have demonstrated mixed results. METHODS: We conducted a systematic review using MEDLINE and EMBASE including all studies examining a volume-outcome relationship in the treatment of patients with head and neck cancer with meta-analysis for long-term survival results. RESULTS: Seventeen studies were identified. Meta-analysis was performed for studies that assessed long-term survival. High-volume hospitals (5 studies; hazard ratio [HR], 0.886; 95% confidence interval [CI], 0.820-0.956) and high-volume surgeons (2 studies; HR, 0.767; 95% CI, 0.641-0.919) have better overall survival than low-volume hospitals and surgeons, respectively. CONCLUSION: Volume-outcome associations exist for head and neck oncologic procedures, although this has not been fully investigated for salivary gland malignancies. Future quality of care studies in head and neck oncology should focus on processes of care, which may explain this relationship.
Authors: Ramez Philips; Daniel Martin; Antoine Eskander; Jeffrey Schord; Nicole Brown; Songzhu Zhao; Guy Brock; Bhavna Kumar; Ricardo Carrau; Enver Ozer; Amit Agrawal; Stephen Y Kang; James W Rocco; David Schuller; Syed Ali; Dukagjin Blakaj; Aashish Bhatt; John Grecula; Theodoros Teknos; Virginia Diavolitsis; Matthew Old Journal: Oral Oncol Date: 2018-01-20 Impact factor: 5.337
Authors: Christine G Gourin; C Matthew Stewart; Kevin D Frick; Carole Fakhry; Karen T Pitman; David W Eisele; J Matthew Austin Journal: JAMA Otolaryngol Head Neck Surg Date: 2019-01-01 Impact factor: 6.223
Authors: Gabriela Hernandez-Meza; Sean McKee; Daniel Carlton; Anthony Yang; Satish Govindaraj; Alfred Iloreta Journal: JAMA Otolaryngol Head Neck Surg Date: 2019-04-01 Impact factor: 6.223
Authors: Evan M Graboyes; Dorina Kallogjeri; Mohammed J Saeed; Margaret A Olsen; Brian Nussenbaum Journal: Laryngoscope Date: 2016-04-21 Impact factor: 3.325
Authors: David W Schoppy; Kim F Rhoads; Yifei Ma; Michelle M Chen; Brian Nussenbaum; Ryan K Orosco; Eben L Rosenthal; Vasu Divi Journal: JAMA Otolaryngol Head Neck Surg Date: 2017-11-01 Impact factor: 6.223
Authors: Evan M Graboyes; Mark A Ellis; Hong Li; John M Kaczmar; Anand K Sharma; Eric J Lentsch; Terry A Day; Chanita Hughes Halbert Journal: Cancer Date: 2018-06-22 Impact factor: 6.860