Samuel J Rubin1, Kevin Y Wu1, Diana N Kirke2, Waleed H Ezzat1, Minh Tam Truong3, Andrew R Salama4, Scharukh Jalisi5. 1. Department of Otolaryngology - Head and Neck Surgery, 1836Boston Medical Center, Boston, MA, USA. 2. Department of Otolaryngology - Head and Neck Surgery, 5944Mount Sinai Health System, New York, NY, USA. 3. Department of Radiation Oncology, 1836Boston Medical Center, Boston, MA, USA. 4. Department of Oral and Maxillofacial Surgery, 1836Boston Medical Center, Boston, MA, USA. 5. Division of Otolaryngology - Head and Neck Surgery, 1859Beth Israel Deaconess Medical Center, Boston, MA, USA.
Abstract
OBJECTIVE: To determine whether surgical case volume is a predictive factor of surgical outcomes when managing geriatric patients with head andneck cancer. METHODS: A cross-sectional study design was used. Data were obtainedfrom the Vizient Database, which included a total of 93 academicinstitutions. Men and women aged between 65 and 100 years undergoing head and neck cancer surgery during 2009 and 2012,excluding cases of thyroid cancer and skin cancer of the head and neck(n = 4544) were included in the study. Hospital case volume was definedas low (≤21 cases/year), moderate (22-49 cases/year), or high (≥50 cases/year). The frequency of comorbidities and complications wasmeasured by hospital case volume using a χ2 test. Significancewas determined with an α level of .05. RESULTS: The largest number of head and neck cancer cases involving comorbidities (90.54%) and the highest rate of overall complications(27.50%) occurred in moderate case volume institutions compared to athe complication rate of 22.89% in low volume hospitals and 21.50% in highvolume hospitals (P < .0001). The most common comorbidities across all3 hospital case volumes included hypertension, metastatic cancer,and chronic pulmonary disease and the most common complicationsincluded hemorrhage/hematoma and postoperative pulmonarycompromise. CONCLUSION: With more geriatric patients requiring surgery for head andneck cancer, it would be beneficial to manage the more complex cases at high volume centers and to develop multidisciplinary teams to optimizecase management and minimize complications.
OBJECTIVE: To determine whether surgical case volume is a predictive factor of surgical outcomes when managing geriatric patients with head andneck cancer. METHODS: A cross-sectional study design was used. Data were obtainedfrom the Vizient Database, which included a total of 93 academicinstitutions. Men and women aged between 65 and 100 years undergoing head and neck cancer surgery during 2009 and 2012,excluding cases of thyroid cancer and skin cancer of the head and neck(n = 4544) were included in the study. Hospital case volume was definedas low (≤21 cases/year), moderate (22-49 cases/year), or high (≥50 cases/year). The frequency of comorbidities and complications wasmeasured by hospital case volume using a χ2 test. Significancewas determined with an α level of .05. RESULTS: The largest number of head and neck cancer cases involving comorbidities (90.54%) and the highest rate of overall complications(27.50%) occurred in moderate case volume institutions compared to athe complication rate of 22.89% in low volume hospitals and 21.50% in highvolume hospitals (P < .0001). The most common comorbidities across all3 hospital case volumes included hypertension, metastatic cancer,and chronic pulmonary disease and the most common complicationsincluded hemorrhage/hematoma and postoperative pulmonarycompromise. CONCLUSION: With more geriatric patients requiring surgery for head andneck cancer, it would be beneficial to manage the more complex cases at high volume centers and to develop multidisciplinary teams to optimizecase management and minimize complications.
Entities:
Keywords:
comorbidities; complications; geriatrics; head and neck cancer; surgical case volume
Authors: Daniel R Dickstein; Eric J Lehrer; Kristin Hsieh; Alexandra Hotca; Brianna M Jones; Ann Powers; Sonam Sharma; Jerry Liu; Vishal Gupta; Loren Mell; Zain Husain; Diana Kirke; Krzysztof Misiukiewicz; Marshall Posner; Eric Genden; Richard L Bakst Journal: Cancers (Basel) Date: 2022-06-05 Impact factor: 6.575