Department of Oral and Maxillofacial Surgery, University of Erlangen-Nürnberg, Erlangen, Germany.
Eur Rev Med Pharmacol Sci. 2019 Apr;23(7):2863-2869. doi: 10.26355/eurrev_201904_17564.
Increasing effort has been put in the implementation and certification of head and neck tumor centers in order to establish standardized, quality assured health care for head and neck tumor patients. This study evaluated survival rates after treatment in a certified head and neck tumor center (CHNTC) vs. a non-certified head and neck tumor center (non-CHNTC) in Middle Franconia, Germany.
Age, sex, possible obituary, and typical relevant prognostic variables were analyzed. Diagnosis was recorded according to ICD10. Clinical and pathological TNM staging, tumor grading, localization, R-stage, and morphology were assessed (ICD-0). Patients diagnosed with oral cancer (N=1047) were divided into groups based on where they received their primary treatment; CHNTCs or non-CHNTCs.
Patients treated at CHNTCs had significantly higher survival rates vs. those treated at non-CHNTC (p=0.023) in univariate analysis. In a Cox regression model, survival rates for patients with pN0 and pN+ stage were similar at both types of centers. Men with pN0 had significantly lower survival rates (HR=0.497, p<0.001). Age had a statistically significant influence on survival rates independently from pN stage (HR=1.031 per year, p<0.001 in both groups).
Patients treated at CHNTC had better survival rates than those treated at non-CHNTC.
为了为头颈部肿瘤患者建立标准化、有质量保证的医疗保健，人们在头颈部肿瘤中心的实施和认证方面付出了更多努力。本研究评估了德国中弗兰肯地区认证的头颈部肿瘤中心（CHNTC）与非认证的头颈部肿瘤中心（non-CHNTC）治疗后的生存率。
分析了年龄、性别、可能的讣告和典型的相关预后变量。根据 ICD10 记录诊断。评估了临床和病理 TNM 分期、肿瘤分级、定位、R 分期和形态（ICD-0）。根据他们接受主要治疗的地点，将诊断为口腔癌的患者（N=1047）分为 CHNTC 或 non-CHNTC 组。
在单因素分析中，在 CHNTC 治疗的患者的生存率明显高于在 non-CHNTC 治疗的患者（p=0.023）。在 Cox 回归模型中，pN0 和 pN+ 期患者在两种类型的中心的生存率相似。pN0 男性的生存率显著降低（HR=0.497，p<0.001）。年龄独立于 pN 分期对生存率有统计学显著影响（HR=1.031/年，两组均 p<0.001）。
在 CHNTC 治疗的患者的生存率高于在 non-CHNTC 治疗的患者。
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