Effect of adjuvant radiotherapy treatment center volume on overall survival. (March 2018)

• Record Type: Journal Article
• Authors: Philips, Ramez; Martin, Daniel; Eskander, Antoine; Schord, Jeffrey; Brown, Nicole; Zhao, Songzhu; Brock, Guy; Kumar, Bhavna; Carrau, Ricardo; Ozer, Enver; Agrawal, Amit; Kang, Stephen Y.; Rocco, James W.; Schuller, David; Ali, Syed; Blakaj, Dukagjin; Bhatt, Aashish; Grecula, John; Teknos, Theodoros; Diavolitsis, Virginia; Old, Matthew
• Is Part Of: Oral oncology. Volume 78(2018)
• Page Start: 46
• Page End: 51
• Publication Date: 2018-03
• Subjects: AJCC American Joint Committee on Cancer -- CI confidence interval -- HHAC historically high accrual centers -- HLAC historically low-accrual centers -- HR hazard ratio -- HVC high volume center -- IMRT intensity-modulated radiation therapy -- LVC low volume center -- OCSCC oral cavity squamous cell carcinoma -- OPSCC oropharynx squamous cell carcinoma -- OSUWMC Ohio State University Wexner Medical Center; Oropharyngeal cancer -- Oral cavity cancer -- Institution volume -- Physician volume -- Radiation therapy -- Adjuvant therapy -- Healthcare outcomes -- Head and neck cancer -- Overall survival; Mouth -- Cancer -- Periodicals; Mouth -- Tumors -- Periodicals; Mouth Diseases -- Periodicals; Mouth Neoplasms -- Periodicals; Bouche -- Cancer -- Périodiques; Bouche -- Tumeurs -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9943105
• DOI: 10.1016/j.oraloncology.2018.01.004
• Languages: English
• ISSNs: 1368-8375

Abstract

Highlights: Volume of adjuvant radiation therapy center is not associated with overall survival. The 5 year OS for patients at a high-volume adjuvant radiation center was 64.8% The 5 year OS for patients at a low-volume adjuvant radiation center was 56.7% Important predictor of survival include age, T-stage, subsite, and ECE. The volume-outcome relationship may be related to primary surgical case volume. Abstract: Objectives: to examine the impact of radiotherapy center volume on overall survival in patients with oral cavity and oropharyngeal squamous cell carcinoma getting adjuvant radiation therapy after receiving surgery at a high-volume center. Materials and Methods: a retrospective study was conducted on patients with oral cavity squamous cell carcinoma or oropharyngeal squamous cell carcinoma treated surgically at a tertiary institution from 2000 to 2012 who received adjuvant radiotherapy. The outcome variable was overall survival and the independent variable was location of adjuvant radiation therapy: high-volume center (HVC) versus low-volume center (LVC). Cox proportional hazards models were used to assess associations between predictors of death. Variables that were found to be significant at the α = 0.10 were included in a multivariable model. Results: 336 patients met inclusion criteria. One-hundred thirty-nine patients received adjuvant radiation therapy at HVC and 197 patients received adjuvant radiation therapy at LVC. A univariate Cox proportional hazards model identified the variables location, age, marital status, subsite, T stage, extracapsular extension, and smoking status to include in a multivariable model. Age, subsite, T stage, and extracapsular extension were independent predictors of overall survival (p < .05). Location (p = .55), marital status (p = .29), and smoking status (p = .22) were not statistically significant predictors of survival. Conclusion: After surgery at a HVC, the volume of adjuvant radiation therapy center was not significantly associated with overall survival. Significant predictors of survival included age, subsite, T stage, and extracapsular extension.