New prediction tool—LIST—with improved prediction accuracy for 30-day readmission rates in patients with head and neck cancer after major cancer surgery

Textbook outcome was associated with better survival in oral cancer surgery in southern Taiwan

“…Second, the cutoff point of 22 days for length of stay was chosen, defined as LOS longer than 66% of the population. It was similar to our previous finding which was associated with a 30‐day readmission rate (Yin et al, 2020). Third, surgery complexity was highly associated with perioperative short‐term outcomes.…”

“…Theoretically, adequate neck dissection defined by lymph node yield, and negative margins were associated with better outcomes (Anderson et al, 2015; Divi et al, 2016). Thirty‐day readmission after major head and neck cancer, and prolonged length of stay, another proxy of imperfect surgery and comorbidities, were associated with worse long‐term outcomes (Jacobs et al, 2021; Yin et al, 2020). Thereafter, overall TO could be regarded as a summation of preoperative evaluation, surgery, and postoperative care.…”

“…The quality metrics of care selected for TO in OCC were derived from the National Comprehensive Cancer Network (NCCN) guidelines for HNC, multidisciplinary quality metrics for HNC from the National Quality Forum, and important quality metrics associated with hospitalization cost or survival rates (Cramer et al, 2017; Divi et al, 2016; van der Heide et al, 2022; Yin et al, 2020). It included five variables: (1) without avoidable readmission within 30 days, (2) without emergency room (ER) visits within 3 days, (3) without length of stay (LOS) more than 22 days (defined as LOS longer than 66% of the population), (4) cervical lymph node yield more than 29 per side, and (5) negative surgical margin.…”

“…Despite recent advances in systemic treatment for recurrent and metastatic head and neck cancers, the cornerstone of treatment for OCC mainly depends on radical surgery with a clear margin and adequate neck dissection, with or without reconstruction (Burtness et al, 2019;Vermorken et al, 2008). Several perioperative indicators, such as lymph node yield, margin status, complication after surgery, and readmission within 30 days of discharge, are associated with long-term survival rates for OCC or head and neck cancer (HNC) (Yang et al, 2021;Yin et al, 2020). However, a well-accepted standard for perioperative quality evaluation in OCC or HNC has not yet been established.Recently, the concept of a composite quality measure textbook outcome (TO), or perfect surgery, has been proposed.…”

Derivation and Validation of the Cancer READMIT Score: A Readmission Risk Scoring System for Patients With Solid Tumor Malignancies

“…The LIST tool, which uses leukocytosis, Charlson comorbidity, LOS, and advanced tumor stage to predict readmission, was derived in a population of patients with head and neck cancer and was shown in the derivation study to have higher prediction accuracy for readmission after major cancer surgery compared with the LACE and HOSPITAL risk scores. 20 Although three of the four LIST variables were similar to our derived score, comorbidity was not shown to be a predictor of readmission in our study. It is unclear as to why, and perhaps is more descriptive of the study population in a comprehensive cancer center that are often referred from other institutions because of progressive, complex, and advanced disease.…”