Department of Otolaryngology-Head & Neck Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, U.S.A.
Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania, U.S.A.
Laryngoscope. 2020 Apr;130(4):946-950. doi: 10.1002/lary.28066. Epub 2019 May 16.
OBJECTIVES/HYPOTHESIS: Although the multidisciplinary tumor board (MTB) is accepted as best practice for the management of head and neck squamous cell carcinoma (HNSCC), there is limited evidence showing its impact on survival. Our goal was to investigate the impact of an MTB following the hiring of a fellowship-trained head and neck surgeon and implementation of an MTB at our institution. We hypothesized that these changes would demonstrate an improvement in survival.
Retrospective chart review.
A review of HNSCC treated at our institution between October 2006 and May 2015 was performed. The cohort was divided into pre-MTB (October 2006-February 2011) and post-MTB (February 2011-May 2015) cohorts. Patient demographics, cancer stage, and treatment outcomes were reviewed. Univariate, multivariate, and survival analysis were performed.
The study included 224 patients, 98 in the pre-MTB cohort and 126 in the post-MTB cohort. Of total patients, 139 (62%) were black and 91 (40%) were on Medicaid or uninsured. Average follow-up time was 2.8 years, and most cases were advanced stage (68%). On Kaplan-Meier evaluation, overall survival and disease-specific survival were significantly improved in the post-MTB cohort compared with the pre-MTB cohort, with a 5-year disease-specific survival of 52% vs. 75% (P = .003). A matched cohort analysis showed that the post-MTB cohort had significantly lower risk of death (hazard ratio: 0.48).
Our study demonstrates that treatment of HNSCC by a dedicated multidisciplinary team results in improved survival. Multidisciplinary care should be considered best practice in the care of HNSCC.
3b Laryngoscope, 130:946-950, 2020.
目的/假设：虽然多学科肿瘤委员会（MTB）被认为是头颈部鳞状细胞癌（HNSCC）管理的最佳实践，但目前仅有有限的证据表明其对生存的影响。我们的目标是研究在聘请了一名接受过 fellowship 培训的头颈部外科医生并在我们机构实施 MTB 之后，MTB 对 HNSCC 治疗的影响。我们假设这些变化将表明生存得到改善。
回顾性图表审查。
对我院 2006 年 10 月至 2015 年 5 月期间治疗的 HNSCC 患者进行了回顾性研究。该队列分为 MTB 前（2006 年 10 月至 2011 年 2 月）和 MTB 后（2011 年 2 月至 2015 年 5 月）队列。回顾患者的人口统计学、癌症分期和治疗结果。进行了单变量、多变量和生存分析。
研究共纳入 224 例患者，MTB 前队列 98 例，MTB 后队列 126 例。所有患者中，139 例（62%）为黑人，91 例（40%）享受医疗补助或没有保险。平均随访时间为 2.8 年，大多数病例为晚期（68%）。Kaplan-Meier 评估显示，MTB 后队列的总生存率和疾病特异性生存率明显优于 MTB 前队列，5 年疾病特异性生存率分别为 52%和 75%（P =.003）。配对队列分析显示，MTB 后队列的死亡风险显著降低（风险比：0.48）。
我们的研究表明，由专门的多学科团队治疗 HNSCC 可提高生存率。多学科护理应被视为 HNSCC 治疗的最佳实践。
3b 喉镜，130：946-950，2020 年。
