Meeting Quality Metrics in Oral Squamous Cell Carcinoma Surgery: A Single-Center Experience

Abstract

Patient-centered quality metrics have been proposed to evaluate and optimize hospital processes, aiming to improve patient outcomes. Furthermore, they can be used to objectively rate and compare the ability of health care providers to meet the needs of their patients. In patients with advanced resectable oral squamous cell carcinoma, optimal surgical treatment of the neck and timely initiation of both surgical and adjuvant therapy, when indicated, are crucial for recurrence-free and overall survival.
 This retrospective analysis included 160 patients who received primary resection of oral squamous cell carcinoma and concurrent neck dissection.It aimed to investigate how well quality metrics were met during a 6-year period in the department of oral and maxillofacial surgery at a university hospital. 93.1% of patients were seen in the specialist's office within 21 days after referral. Resection was classified as R0 in 94.4%. A lymph node yield >= 18 was achieved in 82.5%. The lymph node ratio was <= 6% in 43.3% of nodal-positive necks. Readmission and unplanned revision surgery were rare (6.9%). Adjuvant radiotherapy was started <= 6 weeks after surgery in 45.3%, and the indication was in accordance with international guidelines in all cases. Quality metrics are an effective tool for planning process optimization in a hospital. Moreover, nodal quality metrics such as lymph node yield and lymph node ratio could, after validation, complement existing and well-established prognostic parameters for patient-specific adaptation of adjuvant treatment plans.
 Accepted for publication: November 29, 2022
 Published online: December 15, 2022