Jeffrey C Liu1,2, Adam Kaplon1, Elizabeth Blackman3, Curtis Miyamoto4, Deric Savior5, Camille Ragin3. 1. Department of Otolaryngology-Head & Neck Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, U.S.A. 2. Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania, U.S.A. 3. Cancer Prevention and Control Research Program, Fox Chase Cancer Center, Philadelphia, Pennsylvania, U.S.A. 4. Department of Radiation Oncology, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, U.S.A. 5. Department of Medical Oncology, Fox Chase Cancer Center at Temple University Hospital, Philadelphia, Pennsylvania, U.S.A.
Abstract
OBJECTIVES/HYPOTHESIS: Although the multidisciplinary tumor board (MTB) is accepted as best practice for the management of head and neck squamous cell carcinoma (HNSCC), there is limited evidence showing its impact on survival. Our goal was to investigate the impact of an MTB following the hiring of a fellowship-trained head and neck surgeon and implementation of an MTB at our institution. We hypothesized that these changes would demonstrate an improvement in survival. STUDY DESIGN: Retrospective chart review. METHODS: A review of HNSCC treated at our institution between October 2006 and May 2015 was performed. The cohort was divided into pre-MTB (October 2006-February 2011) and post-MTB (February 2011-May 2015) cohorts. Patient demographics, cancer stage, and treatment outcomes were reviewed. Univariate, multivariate, and survival analysis were performed. RESULTS: The study included 224 patients, 98 in the pre-MTB cohort and 126 in the post-MTB cohort. Of total patients, 139 (62%) were black and 91 (40%) were on Medicaid or uninsured. Average follow-up time was 2.8 years, and most cases were advanced stage (68%). On Kaplan-Meier evaluation, overall survival and disease-specific survival were significantly improved in the post-MTB cohort compared with the pre-MTB cohort, with a 5-year disease-specific survival of 52% vs. 75% (P = .003). A matched cohort analysis showed that the post-MTB cohort had significantly lower risk of death (hazard ratio: 0.48). CONCLUSIONS: Our study demonstrates that treatment of HNSCC by a dedicated multidisciplinary team results in improved survival. Multidisciplinary care should be considered best practice in the care of HNSCC. LEVEL OF EVIDENCE: 3b Laryngoscope, 130:946-950, 2020.
OBJECTIVES/HYPOTHESIS: Although the multidisciplinary tumor board (MTB) is accepted as best practice for the management of head and neck squamous cell carcinoma (HNSCC), there is limited evidence showing its impact on survival. Our goal was to investigate the impact of an MTB following the hiring of a fellowship-trained head and neck surgeon and implementation of an MTB at our institution. We hypothesized that these changes would demonstrate an improvement in survival. STUDY DESIGN: Retrospective chart review. METHODS: A review of HNSCC treated at our institution between October 2006 and May 2015 was performed. The cohort was divided into pre-MTB (October 2006-February 2011) and post-MTB (February 2011-May 2015) cohorts. Patient demographics, cancer stage, and treatment outcomes were reviewed. Univariate, multivariate, and survival analysis were performed. RESULTS: The study included 224 patients, 98 in the pre-MTB cohort and 126 in the post-MTB cohort. Of total patients, 139 (62%) were black and 91 (40%) were on Medicaid or uninsured. Average follow-up time was 2.8 years, and most cases were advanced stage (68%). On Kaplan-Meier evaluation, overall survival and disease-specific survival were significantly improved in the post-MTB cohort compared with the pre-MTB cohort, with a 5-year disease-specific survival of 52% vs. 75% (P = .003). A matched cohort analysis showed that the post-MTB cohort had significantly lower risk of death (hazard ratio: 0.48). CONCLUSIONS: Our study demonstrates that treatment of HNSCC by a dedicated multidisciplinary team results in improved survival. Multidisciplinary care should be considered best practice in the care of HNSCC. LEVEL OF EVIDENCE: 3b Laryngoscope, 130:946-950, 2020.
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