Wen-Chen Tsai1, Pei-Tseng Kung2, Shih-Ting Wang1, Kuang-Hua Huang1, Shih-An Liu3. 1. Department of Health Services Administration, China Medical University, Taichung, Taiwan. 2. Department of Healthcare Administration, Asia University, Taichung, Taiwan. 3. Department of Otolaryngology, Taichung Veterans General Hospital, Taichung, Taiwan; Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan. Electronic address: saliu@vghtc.gov.tw.
Abstract
OBJECTIVES: The aim of this study was to investigate the association between multidisciplinary team (MDT) management and survival of oral cavity cancer patients using a nationwide database in Taiwan. MATERIALS AND METHODS: A nationwide cohort study was conducted between 2005 and 2008. The follow-up end point was 2010. Claims data of oral cavity cancer patients were retrieved from the Taiwan Cancer Registry Database. Secondary data were obtained from the Taiwan's National Health Insurance Research Database. Among 19,766 newly diagnosed oral cavity cancer patients, we identified 16,991 patients who underwent treatment between 2004 and 2008 for further analyses. RESULTS: Overall survival was compared between patients who received MDT management (n=3324) and those who did not (n=13,367). Hazard ratios (HR) of death in patients with MDT management were also analyzed. Patients with MDT management had a lower risk of death when compared with that of patients without MDT management (HR: 0.94, 95% confidence intervals (CI): 0.89-1.00; P=0.032). The effect of MDT management on survival was stronger for male patients than for female patients (HR: 0.94, 95% CI: 0.89-1.00; P=0.040 versus HR: 0.98, 95% CI: 0.75-1.27; P=0.866). In addition, the effect of MDT management was strong among patients with a Charlson Comorbidity Index between 4 and 6, in those without coexisting catastrophic illness/injury, and in patients with stage IV diseases. CONCLUSION: Survival rates in oral cavity cancer patients with MDT management appeared to be marginally better than those of patients without MDT management.
OBJECTIVES: The aim of this study was to investigate the association between multidisciplinary team (MDT) management and survival of oral cavity cancerpatients using a nationwide database in Taiwan. MATERIALS AND METHODS: A nationwide cohort study was conducted between 2005 and 2008. The follow-up end point was 2010. Claims data of oral cavity cancerpatients were retrieved from the Taiwan Cancer Registry Database. Secondary data were obtained from the Taiwan's National Health Insurance Research Database. Among 19,766 newly diagnosed oral cavity cancerpatients, we identified 16,991 patients who underwent treatment between 2004 and 2008 for further analyses. RESULTS: Overall survival was compared between patients who received MDT management (n=3324) and those who did not (n=13,367). Hazard ratios (HR) of death in patients with MDT management were also analyzed. Patients with MDT management had a lower risk of death when compared with that of patients without MDT management (HR: 0.94, 95% confidence intervals (CI): 0.89-1.00; P=0.032). The effect of MDT management on survival was stronger for male patients than for female patients (HR: 0.94, 95% CI: 0.89-1.00; P=0.040 versus HR: 0.98, 95% CI: 0.75-1.27; P=0.866). In addition, the effect of MDT management was strong among patients with a Charlson Comorbidity Index between 4 and 6, in those without coexisting catastrophic illness/injury, and in patients with stage IV diseases. CONCLUSION: Survival rates in oral cavity cancerpatients with MDT management appeared to be marginally better than those of patients without MDT management.
Authors: Laura W J Baijens; Margaret Walshe; Leena-Maija Aaltonen; Christoph Arens; Reinie Cordier; Patrick Cras; Lise Crevier-Buchman; Chris Curtis; Wojciech Golusinski; Roganie Govender; Jesper Grau Eriksen; Kevin Hansen; Kate Heathcote; Markus M Hess; Sefik Hosal; Jens Peter Klussmann; C René Leemans; Denise MacCarthy; Beatrice Manduchi; Jean-Paul Marie; Reza Nouraei; Claire Parkes; Christina Pflug; Walmari Pilz; Julie Regan; Nathalie Rommel; Antonio Schindler; Annemie M W J Schols; Renee Speyer; Giovanni Succo; Irene Wessel; Anna C H Willemsen; Taner Yilmaz; Pere Clavé Journal: Eur Arch Otorhinolaryngol Date: 2020-12-19 Impact factor: 2.503