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Adherence of head and neck squamous cell carcinoma patients to tumor board recommendations

BACKGROUND: Multidisciplinary team (MDT) meetings or tumor boards (TBs) are fundamental components of cancer treatment. Although their primary function is improved outcomes, this aspect is often underreported. The main objective of this study was to analyze the outcomes of patients with head and nec...

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Autores principales: Rangabashyam, Mahalakshmi S., Lee, Shi Yan, Tan, Sher Yin, Mueller, Stefan, Sultana, Rehena, Ho, Johnatton, Skanthakumar, Thakshayeni, Tan, Ngian Chye, Tan, Hiang Khoon, Soo, Khee Chee, Iyer, N. Gopalakrishna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7367636/
https://www.ncbi.nlm.nih.gov/pubmed/32472749
http://dx.doi.org/10.1002/cam4.3097
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author Rangabashyam, Mahalakshmi S.
Lee, Shi Yan
Tan, Sher Yin
Mueller, Stefan
Sultana, Rehena
Ho, Johnatton
Skanthakumar, Thakshayeni
Tan, Ngian Chye
Tan, Hiang Khoon
Soo, Khee Chee
Iyer, N. Gopalakrishna
author_facet Rangabashyam, Mahalakshmi S.
Lee, Shi Yan
Tan, Sher Yin
Mueller, Stefan
Sultana, Rehena
Ho, Johnatton
Skanthakumar, Thakshayeni
Tan, Ngian Chye
Tan, Hiang Khoon
Soo, Khee Chee
Iyer, N. Gopalakrishna
author_sort Rangabashyam, Mahalakshmi S.
collection PubMed
description BACKGROUND: Multidisciplinary team (MDT) meetings or tumor boards (TBs) are fundamental components of cancer treatment. Although their primary function is improved outcomes, this aspect is often underreported. The main objective of this study was to analyze the outcomes of patients with head and neck squamous cell carcinoma (HNSCC) discussed at TBs, and to compare the effect of adherence and nonadherence to recommended treatment plans on outcomes. METHODS: Retrospective data analysis was conducted of HNSCC patients those who were adherent and nonadherent to TB therapy recommendations during 2008‐2009 at a comprehensive cancer center. Fisher's exact test and t test were used for group‐wise comparison, and Kaplan‐Meier and logistic regression models, for survival analysis and determination of the contributing factors to nonadherence. RESULTS: Comprehensive Treatment plans were recommended by TBs in 293 HNSCC patients with curative intent. Seventy‐two patients were excluded based on the selection criteria. Among the remaining 221 patients, 172 (77.9%) were adherent to TB recommendations, while 49 (22.1%) failed to comply. Patient (n = 36; 73.5%), clinician (n = 2; 4.1%), and disease‐related (n = 11; 22.4%) factors were significant contributors to nonadherence. Mean (±standard deviation (SD)) survival time was 55.6 ± 2.32 and 29.1 ± 4 months in the adherent and nonadherent groups, (P < .0001, respectively). Multivariate analyses showed that gender, ethnicity, higher T‐stage, and multimodal treatment were associated with nonadherence. CONCLUSION: Adherence to TB recommendations improved overall survival, reflecting the importance of interdisciplinary expertise in contemporary cancer treatment. Early identification and intervention is crucial in “at risk” patients to prevent subsequent drop‐out from optimal cancer care.
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spelling pubmed-73676362020-07-20 Adherence of head and neck squamous cell carcinoma patients to tumor board recommendations Rangabashyam, Mahalakshmi S. Lee, Shi Yan Tan, Sher Yin Mueller, Stefan Sultana, Rehena Ho, Johnatton Skanthakumar, Thakshayeni Tan, Ngian Chye Tan, Hiang Khoon Soo, Khee Chee Iyer, N. Gopalakrishna Cancer Med Clinical Cancer Research BACKGROUND: Multidisciplinary team (MDT) meetings or tumor boards (TBs) are fundamental components of cancer treatment. Although their primary function is improved outcomes, this aspect is often underreported. The main objective of this study was to analyze the outcomes of patients with head and neck squamous cell carcinoma (HNSCC) discussed at TBs, and to compare the effect of adherence and nonadherence to recommended treatment plans on outcomes. METHODS: Retrospective data analysis was conducted of HNSCC patients those who were adherent and nonadherent to TB therapy recommendations during 2008‐2009 at a comprehensive cancer center. Fisher's exact test and t test were used for group‐wise comparison, and Kaplan‐Meier and logistic regression models, for survival analysis and determination of the contributing factors to nonadherence. RESULTS: Comprehensive Treatment plans were recommended by TBs in 293 HNSCC patients with curative intent. Seventy‐two patients were excluded based on the selection criteria. Among the remaining 221 patients, 172 (77.9%) were adherent to TB recommendations, while 49 (22.1%) failed to comply. Patient (n = 36; 73.5%), clinician (n = 2; 4.1%), and disease‐related (n = 11; 22.4%) factors were significant contributors to nonadherence. Mean (±standard deviation (SD)) survival time was 55.6 ± 2.32 and 29.1 ± 4 months in the adherent and nonadherent groups, (P < .0001, respectively). Multivariate analyses showed that gender, ethnicity, higher T‐stage, and multimodal treatment were associated with nonadherence. CONCLUSION: Adherence to TB recommendations improved overall survival, reflecting the importance of interdisciplinary expertise in contemporary cancer treatment. Early identification and intervention is crucial in “at risk” patients to prevent subsequent drop‐out from optimal cancer care. John Wiley and Sons Inc. 2020-05-30 /pmc/articles/PMC7367636/ /pubmed/32472749 http://dx.doi.org/10.1002/cam4.3097 Text en © 2020 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Cancer Research
Rangabashyam, Mahalakshmi S.
Lee, Shi Yan
Tan, Sher Yin
Mueller, Stefan
Sultana, Rehena
Ho, Johnatton
Skanthakumar, Thakshayeni
Tan, Ngian Chye
Tan, Hiang Khoon
Soo, Khee Chee
Iyer, N. Gopalakrishna
Adherence of head and neck squamous cell carcinoma patients to tumor board recommendations
title Adherence of head and neck squamous cell carcinoma patients to tumor board recommendations
title_full Adherence of head and neck squamous cell carcinoma patients to tumor board recommendations
title_fullStr Adherence of head and neck squamous cell carcinoma patients to tumor board recommendations
title_full_unstemmed Adherence of head and neck squamous cell carcinoma patients to tumor board recommendations
title_short Adherence of head and neck squamous cell carcinoma patients to tumor board recommendations
title_sort adherence of head and neck squamous cell carcinoma patients to tumor board recommendations
topic Clinical Cancer Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7367636/
https://www.ncbi.nlm.nih.gov/pubmed/32472749
http://dx.doi.org/10.1002/cam4.3097
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