Guy Andry1,2, Marc Hamoir3,4, C René Leemans5,3,4. 1. Surgery Department, Centre des Tumeurs ULB, Institut Jules Bordet, Brussels, Belgium. Guy.andry@bordet.be. 2. Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center/Cancer Center Amsterdam, 1007 MB, Amsterdam, The Netherlands. Guy.andry@bordet.be. 3. Department of Head and Neck Surgery, Institut Roi Albert II, UCL, Cliniques Universitaires Saint-Luc, Brussels, Belgium. 4. Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center/Cancer Center Amsterdam, 1007 MB, Amsterdam, The Netherlands. 5. Surgery Department, Centre des Tumeurs ULB, Institut Jules Bordet, Brussels, Belgium.
Abstract
PURPOSE: Quality assurance is much more difficult to achieve in surgical oncology than in medical oncology and radiotherapy where doses are standardized and toxicities are well-classified. To better define what is required in surgery, we analyzed recent articles addressing the point in head and neck surgery. RESULTS: The surgical report should match with the pathological description of the resected specimen with accurate delineation of the margins, number and level(s) of lymph nodes (capsular rupture if any). Complications (minor and major) should be standardized and meticulously recorded; as well as comorbidities and patient status. The acuity of the procedure should be defined by metrics collected in check-lists. Age > 60 years, male gender, tumor site and T4 stage, neck dissection(s), flap reconstruction, alcohol and tobacco consumption, are acknowledged risk factors for more complications and longer hospital stay (or readmission). NEEDS: Randomized controlled trials should be designed adopting the consolidated standards of reporting trials (CONSORT). Training young head and neck surgeons should encompass formation in designing, conducting and interpreting clinical trials.
PURPOSE: Quality assurance is much more difficult to achieve in surgical oncology than in medical oncology and radiotherapy where doses are standardized and toxicities are well-classified. To better define what is required in surgery, we analyzed recent articles addressing the point in head and neck surgery. RESULTS: The surgical report should match with the pathological description of the resected specimen with accurate delineation of the margins, number and level(s) of lymph nodes (capsular rupture if any). Complications (minor and major) should be standardized and meticulously recorded; as well as comorbidities and patient status. The acuity of the procedure should be defined by metrics collected in check-lists. Age > 60 years, male gender, tumor site and T4 stage, neck dissection(s), flap reconstruction, alcohol and tobacco consumption, are acknowledged risk factors for more complications and longer hospital stay (or readmission). NEEDS: Randomized controlled trials should be designed adopting the consolidated standards of reporting trials (CONSORT). Training young head and neck surgeons should encompass formation in designing, conducting and interpreting clinical trials.
Entities:
Keywords:
Head and neck surgery; Quality assurance; Risk factors
Authors: Damien C Weber; Philip M P Poortmans; Coen W Hurkmans; Edwin Aird; Akos Gulyban; Alysa Fairchild Journal: Radiother Oncol Date: 2011-06-29 Impact factor: 6.280
Authors: Carol M Lewis; Marcus M Monroe; Dianna B Roberts; Amy C Hessel; Stephen Y Lai; Randal S Weber Journal: Cancer Date: 2015-01-13 Impact factor: 6.860
Authors: Luigi Santoro; Marta Tagliabue; Maria Angela Massaro; Mohssen Ansarin; Luca Calabrese; Gioacchino Giugliano; Daniela Alterio; Maria Cossu Rocca; Enrica Grosso; Marek Plànicka; Marco Benazzo; Fausto Chiesa Journal: Head Neck Date: 2015-04 Impact factor: 3.147
Authors: Mahmoud I Awad; Andrew G Shuman; Pablo H Montero; Frank L Palmer; Jatin P Shah; Snehal G Patel Journal: Head Neck Date: 2014-06-27 Impact factor: 3.147
Authors: Robert P Takes; Gyorgy B Halmos; John A Ridge; Paolo Bossi; Matthias A W Merkx; Alessandra Rinaldo; Alvaro Sanabria; Ludi E Smeele; Antti A Mäkitie; Alfio Ferlito Journal: Curr Oncol Rep Date: 2020-07-10 Impact factor: 5.075