Improving outcomes in veterans with oropharyngeal squamous cell carcinoma through implementation of a multidisciplinary clinic

被引:20
|
作者
Light, Tyler [1 ,2 ]
El Rassi, Edward [1 ,2 ]
Maggiore, Ronald J. [2 ,3 ]
Holland, John [2 ,4 ]
Reed, Julie [5 ]
Suriano, Kathleen [6 ]
Stooksbury, Marcelle [7 ]
Tobin, Nora [8 ]
Gross, Neil [9 ]
Clayburgh, Daniel [1 ,2 ]
机构
[1] Oregon Hlth & Sci Univ, Dept Otolaryngol Head & Neck Surg, 3181 SW Sam Jackson Pk Rd,PV-01, Portland, OR 97239 USA
[2] VA Portland Hlth Care Syst, Portland, OR USA
[3] Oregon Hlth & Sci Univ, Dept Radiat Oncol, Portland, OR 97201 USA
[4] Oregon Hlth & Sci Univ, Dept Med, Div Hematol Med Oncol, Portland, OR 97201 USA
[5] VA Portland Hlth Care Syst, Operat Care Div, Portland, OR USA
[6] VA Portland Hlth Care Syst, Speech & Language Pathol, Portland, OR USA
[7] VA Portland Hlth Care Syst, Nutr Serv, Portland, OR USA
[8] VA Portland Hlth Care Syst, Div Internal Med, Palliat Care Serv, Portland, OR USA
[9] MD Anderson Canc Ctr, Dept Head & Neck Surg, Houston, TX USA
关键词
oropharyngeal squamous cell carcinoma; multidisciplinary care; survival; treatment outcomes; NECK-CANCER; TREATMENT INITIATION; HUMAN-PAPILLOMAVIRUS; INCREASING TIME; HEAD; SURVIVAL; CARE; RADIOTHERAPY; BEHAVIOR; HEALTH;
D O I
10.1002/hed.24721
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
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. (c) 2017 Wiley Periodicals, Inc.
引用
收藏
页码:1106 / 1112
页数:7
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