Evaluating compliance with process‐related quality metrics and survival in oral cavity squamous cell carcinoma: Multi‐institutional oral cavity collaboration study

Abstract

Background: Process-related measures have been proposed as quality metrics in head and neck cancer care. A recent single-institution study identified four key metrics associated with increased survival. This study sought to validate the association of these quality metrics with survival in a multi-institutional cohort. Methods: Multicenter retrospective study of patients with oral cavity squamous cell (1/2005-1/2015). Baseline patient and disease characteristics and compliance with quality metrics was evaluated. Association between compliance with quality metrics with overall survival (OS), disease-free survival (DFS), and disease-specific survival (DSS) was evaluated using Cox proportional hazards models. Results: Failure to comply with two or more of the quality metrics was associated with worse OS, DFS, and DSS. Adherence to all or all but one of the quality metrics was found to be associated with improved survival. Conclusions: Process-related quality metrics are associated with increased survival in patients with oral cavity squamous cell carcinoma in a multiinstitutional cohort. K E Y W O R D S head and neck cancer survival, multi-institutional study, oral cavity squamous cell carcinoma, process-related metrics, quality metrics This work was presented as a podium presentation at AHNS Annual Meeting held at COSM,

Identifying Opportunities to Deliver High‐Quality Cancer Care Across a Health System: A Clinical Responsibility

“…For HNCs, identifying and evaluating quality of care metrics is important because they can impact patient outcomes. Process‐related quality metrics (eg, lymph node yield [LNY], guideline adherence 8‐10 ) are modifiable measures associated with the care patients receive from health care providers and systems. Graboyes and colleagues identified 4 quality metrics for oral squamous cell carcinoma (OSCC) and found that compliance correlated to improved survival, highlighting the utility of targeting quality metrics to improve patient outcomes 9,10 …”

“…Graboyes and colleagues identified 4 quality metrics for oral squamous cell carcinoma (OSCC) and found that compliance correlated to improved survival, highlighting the utility of targeting quality metrics to improve patient outcomes. 9,10 Provision of high-quality care is critical for patient outcomes and of interest to hospitals and national organizations. Studies report substantial variability in the quality of HNC care delivered across US hospitals.…”

Margin Assessment Methods in Oral Cavity Squamous Cell Carcinoma and Recurrence

“…A fter undergoing surgical resection, patients with oral cavity squamous cell carcinoma (OCSCC) frequently require adjuvant radiation therapy that considers several known risk factors, such as distance to margins and positive surgical margins. 1,2 However, the optimal method for accomplishing intraoperative margin assessment, either from the tumor bed (defect-driven sampling) vs from the resected en bloc specimen (specimen-driven sampling), is not well defined.…”