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Head Neck ; 39(6): 1106-1112, 2017 06.
Article in English | MEDLINE | ID: mdl-28370667

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.


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