Castro Sebastián, Tapia Mario, Cardemil Felipe
Department of Otorhinolaryngology, Hospital San José, Santiago, Chile.
Department of Otorhinolaryngology, Clínica Las Condes, Santiago, Chile.
Int Arch Otorhinolaryngol. 2025 Aug 20;29(3):1-6. doi: 10.1055/s-0045-1802574. eCollection 2025 Jul.
Head and neck cancer are rare and require complex medical and surgical management. Regionalization or centralization of care, defined as the concentration of patients with complex diseases from a specific area in institutions with more experienced and highly functional multidisciplinary teams, may be an alternative to achieve better oncologic outcomes.
To systematize the current knowledge regarding the centralization of care in head and neck oncology and its consequences in the practice of related surgeries.
Currently, there is evidence that this strategy shows better oncologic outcomes in centers with greater volumes, greater adherence to evidence-based clinical guidelines and quality indicators, and a multidisciplinary team in charge of decision-making. The center in Ontario, Canada, is framed as an example of this strategy, achieving improved outcomes while maintaining a high level of quality.
Although more high-quality studies are needed to support this strategy, we believe that the evidence already available is sufficient to consider it a valid option to improve the oncologic outcomes of patients.
头颈癌较为罕见,需要复杂的药物和手术治疗。医疗区域化或集中化,即把特定地区患有复杂疾病的患者集中到拥有经验更丰富、功能更强大的多学科团队的机构,可能是实现更好肿瘤治疗效果的一种选择。
系统整理当前关于头颈肿瘤学护理集中化及其在相关手术实践中的影响的知识。
目前,有证据表明,在病例数量更多、更严格遵循循证临床指南和质量指标且有负责决策的多学科团队的中心,这一策略能带来更好的肿瘤治疗效果。加拿大安大略省的中心就是这一策略的典范,在保持高质量的同时取得了更好的治疗效果。
尽管需要更多高质量研究来支持这一策略,但我们认为现有证据已足以将其视为改善患者肿瘤治疗效果的有效选择。