Cancer Medicine (Jul 2020)
Adherence of head and neck squamous cell carcinoma patients to tumor board recommendations
Abstract
Abstract Background Multidisciplinary team (MDT) meetings or tumor boards (TBs) are fundamental components of cancer treatment. Although their primary function is improved outcomes, this aspect is often underreported. The main objective of this study was to analyze the outcomes of patients with head and neck squamous cell carcinoma (HNSCC) discussed at TBs, and to compare the effect of adherence and nonadherence to recommended treatment plans on outcomes. Methods Retrospective data analysis was conducted of HNSCC patients those who were adherent and nonadherent to TB therapy recommendations during 2008‐2009 at a comprehensive cancer center. Fisher's exact test and t test were used for group‐wise comparison, and Kaplan‐Meier and logistic regression models, for survival analysis and determination of the contributing factors to nonadherence. Results Comprehensive Treatment plans were recommended by TBs in 293 HNSCC patients with curative intent. Seventy‐two patients were excluded based on the selection criteria. Among the remaining 221 patients, 172 (77.9%) were adherent to TB recommendations, while 49 (22.1%) failed to comply. Patient (n = 36; 73.5%), clinician (n = 2; 4.1%), and disease‐related (n = 11; 22.4%) factors were significant contributors to nonadherence. Mean (±standard deviation (SD)) survival time was 55.6 ± 2.32 and 29.1 ± 4 months in the adherent and nonadherent groups, (P < .0001, respectively). Multivariate analyses showed that gender, ethnicity, higher T‐stage, and multimodal treatment were associated with nonadherence. Conclusion Adherence to TB recommendations improved overall survival, reflecting the importance of interdisciplinary expertise in contemporary cancer treatment. Early identification and intervention is crucial in “at risk” patients to prevent subsequent drop‐out from optimal cancer care.
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