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Impact of Hospital Volume on Surgical Outcome for Head and Neck Cancer

  • Head and Neck Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

The objective of this study was to define the prognostic significance of surgical center case volume on outcome for head and neck cancer (HNC). Florida cancer registry and inpatient hospital data were queried for HNC diagnosed from 1998 to 2002. Of the 11,160 operative cases of HNC identified, 35.3% were treated at low-volume centers (LVCs), 32.7% in intermediate-volume centers (IVC), and 32.1% at high-volume centers (HVC). A larger proportion of high-grade tumors (27.9%) and lesions over 30 mm (39.7%) were resected at HVC (p < 0.001). Median survival was 61 months for HVC, 52 months for IVC, and 47 months for LVC (p < 0.001). Univariate analysis demonstrated significantly improved survival at HVC for low-, medium-, and high-grade tumors, small tumors (<30 mm), and for cancers of the parotid, larynx, and pharynx. On multivariate analysis, corrected for patient comorbidities, treatment at a HVC was a significant independent predictor of improved survival (HR = 1.25, p = 0.001). We conclude that HNC patients treated at HVC have significantly better long-term survival and cure rates. Where possible, patients with large (>30 mm), high-grade or parotid, larynx, and pharynx tumors should be evaluated and offered care at a high-volume center.

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Acknowledgement

This work is supported in part by the State of Florida James and Ester King Tobacco Research Grant and the Sylvester Comprehensive Cancer Center.

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Authors and Affiliations

  1. DeWitt Daughtry Family Department of Surgery, Alan Livingstone Chair in Surgical Oncology, University of Miami Miller School of Medicine, 3550 Sylvester Comprehensive Cancer Center, 1475 NW 12th Avenue, Miami, FL, 33136, USA

    Michael C. Cheung, Leonidas G. Koniaris, Eduardo A. Perez & Manuel A. Molina

  2. Department of Otolarnygology, University of Miami, Miller School of Medicine, Miami, FL, 33136, USA

    W. Jarred Goodwin

  3. Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA

    Rabih M. Salloum

Authors
  1. Michael C. Cheung
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  2. Leonidas G. Koniaris
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  3. Eduardo A. Perez
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  4. Manuel A. Molina
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  5. W. Jarred Goodwin
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  6. Rabih M. Salloum
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Correspondence to Leonidas G. Koniaris.

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Cheung, M.C., Koniaris, L.G., Perez, E.A. et al. Impact of Hospital Volume on Surgical Outcome for Head and Neck Cancer. Ann Surg Oncol 16, 1001–1009 (2009). https://doi.org/10.1245/s10434-008-0191-9

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  • DOI: https://doi.org/10.1245/s10434-008-0191-9

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