Impact of treatment expertise on the outcome of patients with head and neck cancer treated within 6 randomized trials

Paolo Bossi, Rosalba Miceli, Marco Benasso, Renzo Corvò, Andrea Bacigalupo, Giuseppe Sanguineti, Carlo Fallai, Marlo C Merlano, Gabriele Infante, Carla Dani, Valerio Di Giannantonio, Lisa Licitra

Research output: Contribution to journalArticle

Abstract

BACKGROUND: We evaluated the impact of center expertise, in terms of number of patients treated, on the overall survival (OS) and progression-free survival (PFS) of patients with head and neck squamous cell carcinoma (SCC).

METHODS: We performed a pooled analysis including data from 6 randomized trials in head and neck SCC conducted in Italy. We evaluated the association between OS or PFS and the number of patients recruited by the center.

RESULTS: The outcome of 903 patients who had received radiotherapy (RT) was analyzed (median follow-up 76 months). The hazard ratio (HR) comparing the third and the first quartiles of the distribution of number of patients per center showed an advantage in PFS (HR 0.59, range 0.53-0.65, P < .0001) and in OS (HR 0.70, 0.60-0.81, P < .0001) for centers with a higher number of patients recruited. A similar benefit was observed in PFS (HR 0.63, 0.60-0.66) and OS (HR 0.74, 0.69-0.79) considering the mean number of patients per year.

CONCLUSIONS: The PFS and OS were longer for patients treated in high-case-volume centers.

Original languageEnglish
Pages (from-to)2648-2656
Number of pages9
JournalHead and Neck Surgery
Volume40
Issue number12
DOIs
Publication statusPublished - Dec 2018

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