Tyler Light1, Edward El Rassi1, Ronald J Maggiore2, John Holland3, Julie Reed4, Kathleen Suriano5, Marcelle Stooksbury6, Nora Tobin7, Neil Gross8, Daniel Clayburgh1. 1. Department of Otolaryngology - Head and Neck Surgery, Oregon Health & Science University and VA Portland Health Care System, Portland, Oregon. 2. Department of Radiation Oncology, Oregon Health & Science University and VA Portland Health Care System, Portland, Oregon. 3. Division of Hematology/Medical Oncology, Department of Medicine, Oregon Health & Science University and VA Portland Health Care System, Portland, Oregon. 4. Operative Care Division, VA Portland Health Care System, Portland, Oregon. 5. Speech and Language Pathology, VA Portland Health Care System, Portland, Oregon. 6. Nutrition Services, VA Portland Health Care System, Portland, Oregon. 7. Palliative Care Service, Division of Internal Medicine, VA Portland Health Care System, Portland, Oregon. 8. Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, Texas.
Abstract
BACKGROUND: Treatment of head and neck cancer is complex, and a multidisciplinary clinic may improve the coordination of care. The value of a head and neck multidisciplinary clinic has not yet been established in oropharyngeal squamous cell carcinoma (SCC). METHODS: A retrospective review was conducted of Veterans Affairs patients with oropharyngeal SCC undergoing concurrent chemoradiation before and after implementation of the head and neck multidisciplinary clinic. RESULTS: Fifty-two patients before and 54 patients after multidisciplinary clinic were included in this study. Age, tobacco use, and p16+ status were similar between groups. With multidisciplinary clinic, time to treatment decreased, and utilization of supportive services, including speech pathology, dentistry, and nutrition increased. The 5-year disease-specific survival rate increased from 63% to 81% (p = .043) after implementation of the multidisciplinary clinic. Multivariate analysis showed that disease stage (p = .016), p16 status (p = .006), and multidisciplinary clinic participation (p = .042) were predictors of disease-specific survival. CONCLUSION: Implementation of a multidisciplinary clinic improved care coordination and disease-specific survival in patients with oropharyngeal SCC.
BACKGROUND: Treatment of head and neck cancer is complex, and a multidisciplinary clinic may improve the coordination of care. The value of a head and neck multidisciplinary clinic has not yet been established in oropharyngeal squamous cell carcinoma (SCC). METHODS: A retrospective review was conducted of Veterans Affairs patients with oropharyngeal SCC undergoing concurrent chemoradiation before and after implementation of the head and neck multidisciplinary clinic. RESULTS: Fifty-two patients before and 54 patients after multidisciplinary clinic were included in this study. Age, tobacco use, and p16+ status were similar between groups. With multidisciplinary clinic, time to treatment decreased, and utilization of supportive services, including speech pathology, dentistry, and nutrition increased. The 5-year disease-specific survival rate increased from 63% to 81% (p = .043) after implementation of the multidisciplinary clinic. Multivariate analysis showed that disease stage (p = .016), p16 status (p = .006), and multidisciplinary clinic participation (p = .042) were predictors of disease-specific survival. CONCLUSION: Implementation of a multidisciplinary clinic improved care coordination and disease-specific survival in patients with oropharyngeal SCC.