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Verleye L, De Gendt C, Leroy R, Stordeur S, Schillemans V, Savoye I, Silversmit G, Van Eycken L, Daisne JF, Nuyts S, Vermorken J, Grégoire V. Patterns and quality of care for head and neck cancer in Belgium: A population-based study. Eur J Cancer Care (Engl) 2021; 30:e13454. [PMID: 33890328 DOI: 10.1111/ecc.13454] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 12/11/2020] [Accepted: 03/18/2021] [Indexed: 02/04/2023]
Abstract
OBJECTIVES We evaluated the quality of care for patients with squamous cell carcinoma (SCC) of the oral cavity, oropharynx, hypopharynx or larynx in Belgium. METHODS Data of the Belgian Cancer Registry were coupled with health insurance data and hospital discharge data. Quality of care and the association with hospital volume were evaluated based on six quality indicators. RESULTS Half of the patients were treated with primary radiotherapy, with or without systemic therapy (49.7%) and 38.1% with surgery, with or without (neo)adjuvant therapy. Single-modality treatment was provided to 78.1% of early-disease patients. Of the patients with cN0 disease, 56.4% underwent neck dissection. Postoperative radiotherapy was completed timely in 48.5% of patients. Concomitant chemotherapy was administered to 58.2% of patients <70 years with locally advanced disease. Imaging of the neck after radiotherapy was performed appropriately in 32.7% of patients. Variability between centres was considerable. No clear relationship between hospital volume and results of the individual QIs was observed. CONCLUSIONS Results show that for the measured QIs, targets are not met and variability between centres is considerable. Through individual feedback, centres are motivated to improve the quality of care for head and neck cancer patients in Belgium.
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Affiliation(s)
- Leen Verleye
- Belgian Health Care Knowledge Centre (KCE), Brussels, Belgium
| | | | - Roos Leroy
- Belgian Health Care Knowledge Centre (KCE), Brussels, Belgium
| | - Sabine Stordeur
- Belgian Health Care Knowledge Centre (KCE), Brussels, Belgium
| | | | - Isabelle Savoye
- Belgian Health Care Knowledge Centre (KCE), Brussels, Belgium
| | | | | | - Jean-Francois Daisne
- CHU-UCL-Namur, Department of radiation oncology, Université Catholique de Louvain, Namur, Belgium.,Department of Radiotherapy-Oncology, KU Leuven, University Hospitals Leuven, University of Leuven, Leuven, Belgium
| | - Sandra Nuyts
- Department of Radiotherapy-Oncology, KU Leuven, University Hospitals Leuven, University of Leuven, Leuven, Belgium
| | - Jan Vermorken
- Department of Medical Oncology, Antwerp University Hospital, Edegem, Belgium.,Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Vincent Grégoire
- Department of Radiation Oncology, Centre Léon Bérard, Lyon, France
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Alterio D, Preda L, Volpe S, Giannitto C, Riva G, Kamga Pounou FA, Atac M, Giugliano G, Bruschini R, Ferrari A, Marvaso G, Cossu Rocca M, Verri E, Rossi D, Bellomi M, Jereczek-Fossa BA, Orecchia R, Ansarin M. Impact of a dedicated radiologist as a member of the head and neck tumour board: a single-institution experience. ACTA ACUST UNITED AC 2021; 40:26-32. [PMID: 32275646 PMCID: PMC7147540 DOI: 10.14639/0392-100x-n0326] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 09/27/2019] [Indexed: 12/24/2022]
Abstract
The aim of this study was to quantify the impact of radiologic image review performed by experienced radiologists in a multidisciplinary team (MDT) for head and neck cancers (HNCs). We performed a retrospective review of cases discussed at MDT meetings from April 2014 to March 2017 for which radiologic review was required. All changes in the former radiologic report were collected and classified as follows: 1) modifications of radiological reports (patients for whom the treatment strategy had not been defined at the moment of MDT meeting) and 2) modifications in treatment strategy (patients for whom treatment strategy had previously been defined and subsequently modified according to the outcome of radiologic revision). The latter subgroup was further categorised as “major changes” and as “minor changes”. A total of 540 cases were retrieved. Imaging review was required at the time of tumour diagnosis in 310 (57.4%) cases. Most patients (69%) had advanced stage tumours (III and IV). In 262 (48%) cases, no change of the initial radiologic report was made. In a total of 144 (27%) cases, the available imaging was not considered sufficient for a final indication to treatment and further imaging was required. In the remaining 134 (25%) cases, radiologic review led to a modification of either tumour staging (55%) or treatment strategy (45%). Specifically, major and minor modifications were applied in 44 (13%) and 17 (11%) of the cases considered, respectively. Among 134 patients for whom the radiologic review led to stage/treatment modification, follow-up was available for 118. In all but one patient, we could confirm the original reports were correctly modified per MDT discussion results. Our data strongly support the importance of including an experienced radiologist as a core member of the MDT for HNCs.
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Affiliation(s)
- Daniela Alterio
- Department of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Lorenzo Preda
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Italy.,Diagnostic Imaging Unit, National Center of Oncological Hadron Therapy (CNAO), Pavia, Italy
| | - Stefania Volpe
- Department of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Italy
| | - Caterina Giannitto
- Department of Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Giulia Riva
- Department of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Italy
| | - Frank Arthur Kamga Pounou
- Department of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Italy
| | - Murat Atac
- Department of Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Gioacchino Giugliano
- Department of Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Roberto Bruschini
- Department of Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Annamaria Ferrari
- Department of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Giulia Marvaso
- Department of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Maria Cossu Rocca
- Department of Head and Neck and Urogenital Medical Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Elena Verri
- Department of Head and Neck and Urogenital Medical Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Duccio Rossi
- Postgraduate School of Radiology, University of Milan, Italy
| | - Massimo Bellomi
- Department of Oncology and Hemato-Oncology, University of Milan, Italy.,Department of Radiology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Barbara Alicja Jereczek-Fossa
- Department of Radiation Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Italy
| | - Roberto Orecchia
- Scientific Directorate, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Mohssen Ansarin
- Department of Head and Neck Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
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