British Association of Head and Neck Oncologists (BAHNO) standards 2020

Schache, Andrew; Kerawala, Cyrus; Ahmed, Omar A.; Brennan, Peter A.; Cook, Florence; Garrett, Matthew; Homer, Jarrod J; Hughes, Charles L.; Mayland, Catriona; Mihai, Radu; Newbold, Kate; O’Hara, James; Roe, Justin; Sibtain, Amen; Smith, Mary Kay; Thavaraj, Selvam; Weller, Alex; Winter, L; Young, Vanessa; Winter, Stuart C

doi:10.1111/jop.13161

Cited by 21 publications

(29 citation statements)

References 2 publications

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“…12,21,22 Given these observations, several authorities recommend SLNB as the standard of care in cT1-2 N0 OSCC, while some professional bodies recommend that all patients with this disease should have access to the procedure. 7,13,14,23 However, despite these guidelines, SLNB remains an underused technique for accurate staging and subsequent management in cT1-2 N0 OSCC. 24,25 There are several potential reasons for the lack of widespread availability of SLNB for OSCC including, but not limited to, equipment costs and the training requirements for surgeons, nuclear physicians and pathologists.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, cost and quality of life analyses appear to favour SNLB over END in these patients 12,21,22 . Given these observations, several authorities recommend SLNB as the standard of care in cT1‐2 N0 OSCC, while some professional bodies recommend that all patients with this disease should have access to the procedure 7,13,14,23 . However, despite these guidelines, SLNB remains an underused technique for accurate staging and subsequent management in cT1‐2 N0 OSCC 24,25 …”

Section: Discussionmentioning

confidence: 99%

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Centralised pathology service for sentinel node biopsy in oral cavity cancer: The Southeast England Consortium experience

Patel

Bowe

Garg

et al. 2022

J Oral Pathology Medicine

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Background Sentinel lymph node biopsy is an increasingly recognised option for accurate staging and subsequent management of the clinically negative neck in early stage oral cavity squamous cell carcinoma. However, the technique is currently underused due to several logistic constraints including increased burden on pathology services. Here, we describe the feasibility of an outsourced centralised pathology processing and reporting service for sentinel lymph node biopsies in oral cavity squamous cell carcinoma. Patients and methods The Southeast England Consortium comprises four surgical centres utilising a central pathology service. Consecutive cases between January 2016 and February 2020 were retrospectively evaluated for survival outcomes and laboratory turnaround times. Results Twenty‐eight per cent from a cohort of 139 patients had positive sentinel nodes. There was a trend towards greater overall, disease‐free and disease‐specific survival (OS, DFS and DSS, respectively) in sentinel node negative compared to sentinel node positive patients, but these differences were not statistically significant. The sensitivity, negative predictive value and false negative rate were 92.8%, 97.0% and 6.8%, respectively. The mean and mode laboratory TAT were 5 and 4 working days, respectively. Conclusion An outsourced centralised pathology service is a feasible option to widen the availability of sentinel node biopsy in oral cavity squamous cell carcinoma.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Centralised pathology service for sentinel node biopsy in oral cavity cancer: The Southeast England Consortium experience

Patel

Bowe

Garg

et al. 2022

J Oral Pathology Medicine

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“…There are a number of alternative guidelines available for management of HNSCCUP which are summarised in table 1 [4][5][6][7][8][9]. However, the authors chose to develop this bespoke methodology for the production of these latest guidelines due to a relative paucity of available evidence and to maximise the potential for adherence to the resultant output.…”

Section: Research In Contextmentioning

confidence: 99%

“…Various methods have been employed to generate national guideline recommendations [1][2][3]. The management of head and neck squamous cell carcinoma of unknown primary (HNSCCUP) has been the subject of a number of these methods which have been used to produce the most widely referenced recommendations [4][5][6][7][8][9]. However, the successful adoption of new guidance into standard practice is not just dependent on assimilation of the best available evidence, but also relies on buy-in from the clinicians delivering day-to-day patient care.…”

Section: Introductionmentioning

confidence: 99%

Methodology for the development of National Multidisciplinary Management Recommendations using a multi-stage meta-consensus initiative

Hardman

Harrington

Roques

et al. 2022

BMC Med Res Methodol

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Background Methods for developing national recommendations vary widely. The successful adoption of new guidance into routine practice is dependent on buy-in from the clinicians delivering day-to-day patient care and must be considerate of existing resource constraints, as well as being aspirational in its scope. This initiative aimed to produce guidelines for the management of head and neck squamous cell carcinoma of unknown primary (HNSCCUP) using a novel methodology to maximise the likelihood of national adoption. Methods A voluntary steering committee oversaw 3 phases of development: 1) clarification of topic areas, data collection and assimilation, including systematic reviews and a National Audit of Practice; 2) a National Consensus Day, presenting data from the above to generate candidate consensus statements for indicative voting by attendees; and 3) a National Delphi Exercise seeking agreement on the candidate consensus statements, including representatives from all 58 UK Head and Neck Multidisciplinary Teams (MDT). Methodology was published online in advance of the Consensus Day and Delphi exercise. Results Four topic areas were identified to frame guideline development. The National Consensus Day was attended by 227 participants (54 in-person and 173 virtual). Results from 7 new systematic reviews were presented, alongside 7 expert stakeholder presentations and interim data from the National Audit and from relevant ongoing Clinical Trials. This resulted in the generation of 35 statements for indicative voting by attendees which, following steering committee ratification, led to 30 statements entering the National Delphi exercise. After 3 rounds (with a further statement added after round 1), 27 statements had reached ‘strong agreement’ (n = 25, 2, 0 for each round, respectively), a single statement achieved ‘agreement’ only (round 3), and ‘no agreement’ could be reached for 3 statements (response rate 98% for each round). Subsequently, 28 statements were adopted into the National MDT Guidelines for HNSCCUP. Conclusions The described methodology demonstrated an effective multi-phase strategy for the development of national practice recommendations. It may serve as a cost-effective model for future guideline development for controversial or rare conditions where there is a paucity of available evidence or where there is significant variability in management practices across a healthcare service.

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“…The current national standard within the United Kingdom recommends that curative head and neck cancer irradiation should commence within 4 weeks of a decision to treat or within 42 days following surgery (British Association of Head and Neck Oncologists, 2009;Schache et al, 2021). Many patients who undergo radiotherapy require exodontia before treatment.…”

Section: Introductionmentioning

confidence: 99%

Is the degree of facial swelling after dental extraction sufficient to justify the current delays to radiotherapy mask production? A pilot evaluation of postextraction swelling using 3D photography

McCormick

Meechan

Adams

et al. 2022

Clinical & Exp Dental Res

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Background Concern that facial swelling after dental extractions will spoil the fit of radiotherapy masks in head and neck cancer patients leads to the current practice of delay making of mask production (and therefore the start of radiotherapy) for several days or longer. However, there is little data on how extensive facial swelling is after dental extraction. Aim To assess the degree of facial swelling in a group of adult patients attending Newcastle Dental School for routine dental extractions. Materials and Methods Seventeen dental extraction patients underwent three‐dimensional photography using the 3dMDFace® system at 1‐week preop, immediately preop, and at 48‐h postop. We recorded demographic data, teeth extracted, and methods. Facial volume change was assessed using 3dMD Vultus® software. Two reviewers ran the data through the 3dMD Vultus® software independently. We used Student's t ‐test to assess significance. Results Twelve patients were included in the final analysis. There was no significant difference in the difference between the two preoperative measurements and the preoperative versus postoperative difference (Wilcoxon signed‐rank test: Reviewer 1: p = .31. and Reviewer 2: p = .10). Thus, mean facial swelling was less than the threshold for significant swelling which was deemed to be 15 cm 3 . Conclusion Facial swelling following dental extraction may not be sufficient in itself to justify the current delays in mask production and subsequent delivery of radiotherapy. Further definitive studies are needed to optimize how dental extractions should be timed within head and neck cancer care pathways.

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British Association of Head and Neck Oncologists (BAHNO) standards 2020

Cited by 21 publications

References 2 publications

Centralised pathology service for sentinel node biopsy in oral cavity cancer: The Southeast England Consortium experience

Centralised pathology service for sentinel node biopsy in oral cavity cancer: The Southeast England Consortium experience

Methodology for the development of National Multidisciplinary Management Recommendations using a multi-stage meta-consensus initiative

Is the degree of facial swelling after dental extraction sufficient to justify the current delays to radiotherapy mask production? A pilot evaluation of postextraction swelling using 3D photography

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