Head & Neck Institute Outcomes
Head and Neck Surgery and Oncology
Evaluating Compliance With Process-Related Quality Metrics and Survival in Oral Cavity Squamous Cell Carcinoma
2005-2015
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.
Overall Survival of Patients With Oral Cavity Squamous Cell Carcinoma (N = 773)
2005-2015
| Months After Surgery | 0 | 24 | 48 | 72 | 96 | 120 | 144 | 168 |
|---|---|---|---|---|---|---|---|---|
| Number at risk | 773 | 539 | 369 | 228 | 110 | 60 | 8 | 2 |
Disease-Free Survival of Patients With Oral Cavity Squamous Cell Carcinoma (N = 738)
2005-2015
| Months After Surgery | 0 | 24 | 48 | 72 | 96 | 120 | 144 | 168 |
|---|---|---|---|---|---|---|---|---|
| Number at risk | 738 | 445 | 282 | 177 | 71 | 39 | 6 | 2 |
Disease-Specific Survival of Patients With Oral Cavity Squamous cell Carcinoma
2005-2015
| Months After Surgery | 0 | 24 | 48 | 72 | 96 | 120 | 144 | 168 |
|---|---|---|---|---|---|---|---|---|
| Number at Risk | 719 | 514 | 356 | 222 | 106 | 57 | 7 | 2 |
Overall Survival by Care Quality Metric Compliance (N = 773)
2005-2015
| Months After Surgery | 24 | 48 | 72 | 96 | 120 | 144 | 168 |
|---|---|---|---|---|---|---|---|
| All Metrics (N = 507) | 343 | 234 | 139 | 58 | 33 | 6 | 2 |
| Missed One (N = 240) | 181 | 129 | 85 | 49 | 25 | 2 | 0 |
| Missed Two or More (N = 26) | 15 | 6 | 4 | 3 | 2 | 0 | 0 |
Disease-Free Survival by Care Quality Metric Compliance (N = 738)
2005-2018
| Months After Surgery | 24 | 48 | 72 | 96 | 120 | 144 | 168 |
|---|---|---|---|---|---|---|---|
| All Metrics (N = 474) | 283 | 175 | 111 | 39 | 22 | 4 | 2 |
| Missed One (N = 238) | 153 | 104 | 64 | 31 | 16 | 2 | 0 |
| Missed Two or More (N = 26) | 9 | 3 | 2 | 1 | 1 | 0 | 0 |
Disease-Specific Survival by Care Quality Metric Compliance (N = 719)
2005-2015
| Months After Surgery | 24 | 48 | 72 | 96 | 120 | 144 | 168 |
|---|---|---|---|---|---|---|---|
| All Metrics (N = 468) | 326 | 224 | 135 | 55 | 31 | 5 | 2 |
| Missed One (N = 228) | 174 | 127 | 84 | 49 | 25 | 2 | 0 |
| Missed Two or More (N = 23) | 14 | 5 | 3 | 2 | 1 | 0 | 0 |
In this cohort of patients with OCSCC, adherence with a core group of four process-related quality metrics was found to be significantly associated with disease outcomes and mortality. Patients who underwent unplanned surgery within 14 days or had unplanned readmission within 30 days were found to have worse OS. Disease-free survival was found to be improved in patients who received a referral for adjuvant radiotherapy for stage III or IV disease. Patients with two or more unmet key quality metrics were shown to have worsened survival.
