Abstract
Background
Because there are few exchanges of doctors and surgical techniques among leading Japanese hospitals, neck dissections in Japan have become so highly diverse that the uniformity and comparability of nonradical neck dissections have become questionable.
Methods
The Japan Neck Dissection Study Group (JNDSG) was organized in 2002 and includes 22 leading Japanese hospitals as members. To enhance exchanges among member hospitals and standardize nonradical neck dissections, JNDSG planned and conducted a prospective study, in which surgeons from participating hospitals were directed to observe neck dissections conducted by surgeons in other hospitals. To standardize the observation method, JNDSG created a specialized form consisting of 79 questions regarding details of neck dissection.
Results
A total of 235 patients were enrolled between February 18, 2004 and November 22, 2006. Of the 79 questions, difference among participating hospitals was confirmed in 13 details and strongly suspected in 7 details. To standardize these 20 details, JNDSG established a manual, “Standard Surgical Maneuvers for Each Detail of Neck Dissection,” based on the discussion about the optimal procedures concerning each detail. As the study proceeded from the first to the second stage, the intensity of difference among the hospitals decreased in 11 details and increased in 6 details. Because there were more details showing decreased intensity, this study was concluded to have contributed to some extent to the standardization of nonradical neck dissections in Japan.
Conclusions
Although standardization of a surgical procedure in a multi-institutional setting is a very rare undertaking, this study achieved noteworthy success.
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Acknowledgments
The authors would like to express their deep gratitude to the other members of JNDSG: Kazuyoshi Kawabata (Cancer Institute Hospital, Tokyo), Yasuhisa Hasegawa (Aichi Cancer Center Hospital), Ken-ichi Nibu (Graduate School of Medicine, Kobe University), Madoka Furukawa (Kanagawa Cancer Center), Wataru Nishijima (Saitama Cancer Center), Takashi Fujii (Osaka Medical Center for Cancer and Cardiovascular Diseases), Kazuto Matsuura (Miyagi Cancer Center), Yasushi Fujimoto (Nagoya University Graduate School of Medicine), Takahiro Asakage (Graduate School of Medicine, University of Tokyo), Nobuhiro Hanai (Aichi Cancer Center Hospital), Tadashi Nakashima (Kurume University School of Medicine), Masao Asai (National Cancer Center Hospital), Masashi Sugasawa (Saitama Medical School), Meijin Nakayama (Kitasato University School of Medicine), Nobuya Monden (National Hospital Organization Shikoku Cancer Center), Yorihisa Imanishi (Keio University School of Medicine), Hiroya Ojiri (The Jikei University School of Medicine), Masakazu Miyazaki (National Cancer Center Hospital East), Kichinobu Tomita (National Kyushu Cancer Center), Masato Fujii (National Hospital Organization Tokyo Medical Center), Naoyuki Kohno (Kyorin University School of Medicine), Hiroaki Nakatani (Kochi Medical School), Katsuyuki Doi (Chiba Cancer Center Hospital), Tetsuro Onitsuka (Shizuoka Cancer Center), and Morimasa Kitamura (Graduate School of Medicine, Kyoto University). This study was supported by a Health and Labour Sciences Research Grant for Clinical Cancer Research (H20-Gannrinshou-Ippan-014) from the Ministry of Health, Labour and Welfare, Japan.
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Saikawa, M., Kishimoto, S. Standardizing the extent of resection in nonradical neck dissections: the final report of the Japan Neck Dissection Study Group prospective study. Int J Clin Oncol 15, 13–22 (2010). https://doi.org/10.1007/s10147-009-0016-2
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DOI: https://doi.org/10.1007/s10147-009-0016-2