Elucidating survival and functional outcomes in patients with primary head and neck malignancies treated in academic versus community settings

• Published in: Head & neck Vol. 46; no. 2; pp. 398 - 407
• Main Authors: Choi, Karen Y., Patel, Shivam D., Lane, Ciaran, Tucker, Jacqueline, Chan, Kimberly, Pradhan, Sandeep, Mahase, Sean S., Tam, Samantha H., King, Tonya S.
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01-02-2024; Wiley Subscription Services, Inc
• Subjects: academic center; Chemoradiotherapy - adverse effects; community center; definitive chemoradiation; feeding tube dependency; Gastrostomy; Head & neck cancer; head and neck cancer; Head and Neck Neoplasms - etiology; Head and Neck Neoplasms - therapy; Humans; Malignancy; Regression analysis; Retrospective Studies; Survival; Treatment Outcome; definitive chemoradiation; feeding tube dependency; head and neck cancer; academic center; community center
• ISSN: 1043-3074; 1097-0347; 1097-0347
• DOI: 10.1002/hed.27588

Background
Differences in treatment outcomes between community or academic centers are incompletely understood.
Methods
Retrospective review of head and neck cancer patients between 2010 and 2020 in a rural health region. Kaplan–Meier curves and log‐rank tests were used to evaluate survival outcomes, along with bivariate and multivariable Cox proportional hazards models. Linear regression was used for functional outcomes of tracheotomy and gastrostomy tube dependence.
Results
Two hundred and forty‐eight patients treated at an academic center were compared with 94 patients treated in community centers. In multivariable analysis, the risk of death (HR = 0.60, p = 0.019), and risk of recurrence were lower (HR = 0.29, p < 0.001) for patients treated in academic centers. Patients treated in community centers had longer gastrostomy tube dependence (p = 0.002).
Conclusion
Our findings suggest that treatment at an academic center was associated with a lower risk of recurrence and shorter gastrostomy tube dependence compared to treatment in the community.