Timothy Liu1, Michael David2, Owen Ellis3, Tsu-Hui Hubert Low4, Carsten E Palme4, Jonathan Clark4, Martin Batstone5. 1. Oral and Maxillofacial Surgery, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia; School of Medicine, University of Queensland, St Lucia, Queensland, Australia. Electronic address: liupi090@yahoo.com. 2. School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia. 3. Oral and Maxillofacial Surgery, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia. 4. Central Clinical School, University of Sydney, Sydney, New South Wales, Australia; Sydney Head and Neck Cancer Institute, Chris O'Brien Lifehouse, Sydney, New South Wales, Australia. 5. Oral and Maxillofacial Surgery, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia; School of Medicine, University of Queensland, St Lucia, Queensland, Australia.
Abstract
BACKGROUND: The volume-outcome relationship is a well-known phenomenon in surgical oncology. The aim of this study was to quantify the impact of surgeon volume on the treatment outcome of oral squamous cell carcinoma (OSCC) patients. METHODS: All new OSCC cases treated with curative intent between 2008 and 2013 were included. A heterogeneous set of predictor variables was collected, including patient, tumour and treatment factors. The outcomes of interest were recurrence-free survival (RFS), overall survival (OS) and disease-specific survival (DSS). To investigate the cut-off in surgeon volume, the number of OSCC resections was analysed in multiplies of 5 cases per annum according to DSS, using univariable regression analysis. RESULTS: 534 cases were recruited. Independently, the negative predictors for patient survival were age, perineural invasion, worsening tumour staging, and extracapsular spread. High-volume surgeon was determined to be most significant at 20 cases per annum and significantly associated with improved RFS (HR: 0.67), OS (HR: 0.44), and DSS (HR: 0.39). CONCLUSIONS: Results from this study support the rationalisation of OSCC management at high-volume centres and in the hands of experienced surgeons for better patient survival. Head and neck surgeons should perform a minimum of 20 OSCC cases per year to maintain competency in OSCC ablation. Crown
BACKGROUND: The volume-outcome relationship is a well-known phenomenon in surgical oncology. The aim of this study was to quantify the impact of surgeon volume on the treatment outcome of oral squamous cell carcinoma (OSCC) patients. METHODS: All new OSCC cases treated with curative intent between 2008 and 2013 were included. A heterogeneous set of predictor variables was collected, including patient, tumour and treatment factors. The outcomes of interest were recurrence-free survival (RFS), overall survival (OS) and disease-specific survival (DSS). To investigate the cut-off in surgeon volume, the number of OSCC resections was analysed in multiplies of 5 cases per annum according to DSS, using univariable regression analysis. RESULTS: 534 cases were recruited. Independently, the negative predictors for patient survival were age, perineural invasion, worsening tumour staging, and extracapsular spread. High-volume surgeon was determined to be most significant at 20 cases per annum and significantly associated with improved RFS (HR: 0.67), OS (HR: 0.44), and DSS (HR: 0.39). CONCLUSIONS: Results from this study support the rationalisation of OSCC management at high-volume centres and in the hands of experienced surgeons for better patient survival. Head and neck surgeons should perform a minimum of 20 OSCC cases per year to maintain competency in OSCC ablation. Crown
Authors: Sagar A Patel; Subir Goyal; Yuan Liu; Drew Moghanaki; Pretesh R Patel; Sheela Hanasoge; Vishal R Dhere; Jay W Shelton; Karen D Godette; Ashesh B Jani; Bruce Hershatter; Benjamin W Fischer-Valuck Journal: JAMA Netw Open Date: 2020-12-01
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