Treatment for oral squamous cell carcinoma: Impact of surgeon volume on survival
| Autor: | Owen G. Ellis, Timothy Liu, Carsten E. Palme, Jonathan R. Clark, Tsu-Hui Hubert Low, Michael David, Martin D. Batstone |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Oncology Cancer Research medicine.medical_specialty Adolescent Treatment outcome Perineural invasion Predictor variables Young Adult 03 medical and health sciences 0302 clinical medicine Surgical oncology Internal medicine Humans Medicine Basal cell 030223 otorhinolaryngology Head and neck Surgeon volume Aged Aged 80 and over business.industry Tumour staging Middle Aged Survival Analysis stomatognathic diseases 030220 oncology & carcinogenesis Carcinoma Squamous Cell Female Mouth Neoplasms Oral Surgery business |
| Zdroj: | Oral Oncology. 96:60-65 |
| ISSN: | 1368-8375 |
| DOI: | 10.1016/j.oraloncology.2019.06.030 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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