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

Head Neck. 2017 Jun;39(6):1106-1112. doi: 10.1002/hed.24721. Epub 2017 Mar 29.

Abstract

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. © 2017 Wiley Periodicals, Inc. Head Neck 39: 1106-1112, 2017.

Keywords: multidisciplinary care; oropharyngeal squamous cell carcinoma; survival; treatment outcomes.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Ambulatory Care / organization & administration*
  • Ambulatory Care Facilities / organization & administration
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / therapy*
  • Chemoradiotherapy / methods*
  • Cohort Studies
  • Confidence Intervals
  • Disease-Free Survival
  • Female
  • Head and Neck Neoplasms / mortality
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / therapy*
  • Humans
  • Interdisciplinary Communication
  • Male
  • Middle Aged
  • Odds Ratio
  • Oropharyngeal Neoplasms / mortality
  • Oropharyngeal Neoplasms / pathology
  • Oropharyngeal Neoplasms / therapy*
  • Outcome Assessment, Health Care
  • Patient Care Team / organization & administration*
  • Prognosis
  • Quality Improvement*
  • Retrospective Studies
  • Risk Assessment
  • Squamous Cell Carcinoma of Head and Neck
  • Survival Analysis
  • Treatment Outcome
  • United States
  • Veterans