- Title
- Treatment for oral squamous cell carcinoma: impact of surgeon volume on survival
- Creator
- Liu, Timothy; David, Michael; Ellis, Owen; Low, Tsu-Hui (Hubert); Palme, Carsten E.; Clark, Jonathan; Batstone, Martin
- Relation
- Oral Oncology Vol. 96, Issue September 2019, p. 60-65
- Publisher Link
- http://dx.doi.org/10.1016/j.oraloncology.2019.06.030
- Publisher
- Elsevier
- Resource Type
- journal article
- Date
- 2019
- Description
- Background: The volume-outcome relationship is a well-known phenomenon in surgical oncology. The aim of this study was to quantify the impact of surgeon volume on the treatment outcome of oral squamous cell carcinoma (OSCC) patients. Methods: All new OSCC cases treated with curative intent between 2008 and 2013 were included. A heterogeneous set of predictor variables was collected, including patient, tumour and treatment factors. The outcomes of interest were recurrence-free survival (RFS), overall survival (OS) and disease-specific survival (DSS). To investigate the cut-off in surgeon volume, the number of OSCC resections was analysed in multiplies of 5 cases per annum according to DSS, using univariable regression analysis. Results: 534 cases were recruited. Independently, the negative predictors for patient survival were age, perineural invasion, worsening tumour staging, and extracapsular spread. High-volume surgeon was determined to be most significant at 20 cases per annum and significantly associated with improved RFS (HR: 0.67), OS (HR: 0.44), and DSS (HR: 0.39). Conclusions: Results from this study support the rationalisation of OSCC management at high-volume centres and in the hands of experienced surgeons for better patient survival. Head and neck surgeons should perform a minimum of 20 OSCC cases per year to maintain competency in OSCC ablation.
- Subject
- oral cancer; squamous cell carcinoma; surgeon; volume; survival; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1463916
- Identifier
- uon:46867
- Identifier
- ISSN:1368-8375
- Language
- eng
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