Case volume regionalization and volume‐based outcome differences in cutaneous head and neck melanoma. Issue 11 (29th July 2022)

• Record Type: Journal Article
• Authors: Roman, Kelsey M.; Torabi, Sina J.; Goshtasbi, Khodayar; Kuan, Edward C.; Tjoa, Tjoson; Haidar, Yarah M.
• Is Part Of: Head & neck. Volume 44:Issue 11(2022)
• Page Start: 2428
• Page End: 2436
• Publication Date: 2022-07-29
• Subjects: cutaneous melanoma -- facility volume -- head and neck cancer -- otolaryngology -- regionalization -- skin melanoma; Head -- Diseases -- Periodicals; Neck -- Diseases -- Periodicals; Head -- Periodicals; Neck -- Periodicals; Face -- Periodicals; 617.51059
• DOI: 10.1002/hed.27150
• Languages: English
• ISSNs: 1043-3074

Abstract

Abstract: Background: Hospital volume has emerged as a prognostic factor in oncology but is not currently known whether volume is associated with improved outcomes for cutaneous head and neck (HN) melanoma. Methods: A total of 556 079 cutaneous melanoma cases reported by the 2004–2016 National Cancer Database were separated into two cohorts (HN and non‐HN) and facilities within each cohort were classified by case volume. Analysis employed chi‐square, analysis of variance, Kaplan–Meier, and Cox proportional hazards models. Results: Only 41 facilities (3.1% of 1326) treating HN melanoma and 50 facilities (3.7% of 1344) treating non‐HN melanoma were classified as high‐volume facilities (HVFs). The estimated 5‐year overall survival (OS) was 62.7% (standard error [SE]: 0.4%) for patients with HN at low‐volume facilities (LVFs), 69.3% (SE: 0.4%) at IVFs, and 71.8% (SE 0.4%) at HVFs ( p < 0.001). Differences in OS remained significant between HVFs versus LVFs after adjusting for confounders. Conclusion: Volume is independently associated with OS and improved surgical outcomes for HN melanoma.