Department of Oral and Maxillofacial Surgery, German Armed Forces Central Hospital, Rübenacherstr. 170, 56072, Koblenz, Germany.
Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany.
Clin Oral Investig. 2024 Aug 6;28(9):469. doi: 10.1007/s00784-024-05859-0.
This study analyzed oncologic patient management from initial tumor diagnosis to tumor follow-up in oral and maxillofacial surgery (OMFS) in Germany.
A dynamic online questionnaire with a total of 44 questions was used to generate general and specific data regarding oncologic patient management with head and neck malignancies, supportive care, and (pre-) rehabilitation from initial tumor diagnosis to tumor follow-up and head and neck cancer center (HNCC) structures in OMFS in Germany. The questionnaire was sent to 81 OMFS departments affiliated with the German-Austrian-Swiss Working Group for Tumors of the Jaw and Facial Region (DÖSAK) and the German Association of Oral and Maxillofacial Surgery (DGMKG). Data analysis was conducted descriptively.
Forty-eight OMFS departments participated (response rate 59.26%), of which 36/48 (75%) were certified HNCC. 28/34 (82.4%) reported subjective improvements in oncologic care, most often interdisciplinary collaboration (21/33, 63.64%) and clinic structure changes (21/34, 61.76%). Nearly all OMFS departments present patients in multidisciplinary tumor boards (45/46, 97.83%) and aim for osseous reconstruction post-tumor resection (43/44, 97.73%). Significant discrepancies regarding the frequency of masticatory-functional dental rehabilitation following osseous reconstruction were observed. Before oncologic therapy, patients are offered various supportive services, mostly psychotherapy and psycho-oncological support (24/26, 92.31%). Post-therapy, speech therapy (43/43, 100%), physiotherapy (40/43, 93.02%), lymphatic drainage, and follow-up rehabilitation (39/43, 90.7%, respectively) are most often offered. 17/43 (39.53%) have oncological nursing staff. 36/40 (90%) manage patients and side effects during adjuvant therapy, while 5/41 (12.2%) provide proprietary palliative care. 36/41 (87.8%) offer counseling to patients and families.
Oncologic patient care in OMFS is highly standardized and potentially attributable to many certified HNCCs in Germany. Certain treatment aspects are handled differently, possibly due to institution-specific reasons.
The high homogeneity in treatment protocols reflects the widespread high and comparable treatment quality of head and neck malignancies in OMFS in Germany.
本研究分析了德国口腔颌面外科（OMFS）中从初始肿瘤诊断到肿瘤随访的肿瘤患者管理情况。
使用总共 44 个问题的动态在线问卷，生成有关头颈部恶性肿瘤、支持性护理以及（术前）康复的肿瘤患者管理的一般和具体数据，以及德国 OMFS 中从初始肿瘤诊断到肿瘤随访和头颈部癌症中心（HNCC）结构的信息。问卷发送给了德国-奥地利-瑞士下颌和面部区域肿瘤工作组（DÖSAK）和德国口腔颌面外科学会（DGMKG）附属的 81 个 OMFS 部门。数据分析采用描述性方法进行。
48 个 OMFS 部门参与（回应率 59.26%），其中 36/48（75%）为认证的 HNCC。28/34（82.4%）报告称肿瘤护理的改善，最常见的是多学科合作（21/33，63.64%）和临床结构变化（21/34，61.76%）。几乎所有 OMFS 部门都在多学科肿瘤委员会中展示患者（45/46，97.83%），并旨在进行肿瘤切除后的骨重建（43/44，97.73%）。在骨重建后的咀嚼-功能性牙康复频率方面存在显著差异。在进行肿瘤治疗之前，患者通常会接受各种支持性服务，主要是心理治疗和心理肿瘤学支持（24/26，92.31%）。治疗后，语言治疗（43/43，100%）、物理治疗（40/43，93.02%）、淋巴引流和后续康复（39/43，90.7%，分别）最常提供。17/43（39.53%）有肿瘤护理人员。36/40（90%）管理辅助治疗期间的患者和副作用，而 5/41（12.2%）提供专有的姑息治疗。36/41（87.8%）为患者及其家属提供咨询。
OMFS 中的肿瘤患者护理高度标准化，这可能归因于德国众多认证的 HNCC。某些治疗方面的处理方式不同，可能是由于机构特定的原因。
治疗方案的高度同质性反映了德国 OMFS 中头颈部恶性肿瘤治疗质量的广泛提高和可比性。
