Effect of adjuvant radiotherapy treatment center volume on overall survival

Publication date: March 2018
Source:Oral Oncology, Volume 78
Author(s): Ramez Philips, Daniel Martin, Antoine Eskander, Jeffrey Schord, Nicole Brown, Songzhu Zhao, Guy Brock, Bhavna Kumar, Ricardo Carrau, Enver Ozer, Amit Agrawal, Stephen Y. Kang, James W. Rocco, David Schuller, Syed Ali, Dukagjin Blakaj, Aashish Bhatt, John Grecula, Theodoros Teknos, Virginia Diavolitsis, Matthew Old
Objectivesto examine the impact of radiotherapy center volume on overall survival in patients with oral cavity and oropharyngeal squamous cell carcinoma getting adjuvant radiation therapy after receiving surgery at a high-volume center.Materials and Methodsa retrospective study was conducted on patients with oral cavity squamous cell carcinoma or oropharyngeal squamous cell carcinoma treated surgically at a tertiary institution from 2000 to 2012 who received adjuvant radiotherapy. The outcome variable was overall survival and the independent variable was location of adjuvant radiation therapy: high-volume center (HVC) versus low-volume center (LVC). Cox proportional hazards models were used to assess associations between predictors of death. Variables that were found to be significant at the α = 0.10 were included in a multivariable model.Results336 patients met inclusion criteria. One-hundred thirty-nine patients received adjuvant radiation therapy at HVC and 197 patients received adjuvant radiation therapy at LVC. A univariate Cox proportional hazards model identified the variables location, age, marital status, subsite, T stage, extracapsular extension, and smoking status to include in a multivariable model. Age, subsite, T stage, and extracapsular extension were independent predictors of overall survival (p < .05). Location (p = .55), marital status (p = .29), and smoking status (p = .22) were not statistically significant predictors of survival.ConclusionAfter surgery at a HVC, the volume of adjuvant radiation therapy center was not significantly associated with overall survival. Significant predictors of survival included age, subsite, T stage, and extracapsular extension.



http://ift.tt/2n1VYK1