title: Improving outcomes in veterans with oropharyngeal squamous cell carcinoma through implementation of a multidisciplinary clinic.
abstract: Treatment of head and neck cancer is complex, and a multidisciplinary clinic may improve the coordination of care. The value of a head and neck multidisciplinary clinic has not yet been established in oropharyngeal squamous cell carcinoma (SCC).
  
  
  
  A retrospective review was conducted of Veterans Affairs patients with oropharyngeal SCC undergoing concurrent chemoradiation before and after implementation of the head and neck multidisciplinary clinic.
  
  
  
  Fifty-two patients before and 54 patients after multidisciplinary clinic were included in this study. Age, tobacco use, and p16+ status were similar between groups. With multidisciplinary clinic, time to treatment decreased, and utilization of supportive services, including speech pathology, dentistry, and nutrition increased. The 5-year disease-specific survival rate increased from 63% to 81% (p = .043) after implementation of the multidisciplinary clinic. Multivariate analysis showed that disease stage (p = .016), p16 status (p = .006), and multidisciplinary clinic participation (p = .042) were predictors of disease-specific survival.
  
  
  
  Implementation of a multidisciplinary clinic improved care coordination and disease-specific survival in patients with oropharyngeal SCC. © 2017 Wiley Periodicals, Inc. Head Neck 39: 1106-1112, 2017.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Oregon Health & Science University and VA Portland Health Care System, Portland, Oregon.
authors.forename: Tyler
authors.initials: T
authors.lastname: Light
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Oregon Health & Science University and VA Portland Health Care System, Portland, Oregon.
authors.forename: Edward El
authors.initials: EE
authors.lastname: Rassi
authors.affiliation: Department of Radiation Oncology, Oregon Health & Science University and VA Portland Health Care System, Portland, Oregon.
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Maggiore
authors.affiliation: Division of Hematology/Medical Oncology, Department of Medicine, Oregon Health & Science University and VA Portland Health Care System, Portland, Oregon.
authors.forename: John
authors.initials: J
authors.lastname: Holland
authors.affiliation: Operative Care Division, VA Portland Health Care System, Portland, Oregon.
authors.forename: Julie
authors.initials: J
authors.lastname: Reed
authors.affiliation: Speech and Language Pathology, VA Portland Health Care System, Portland, Oregon.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Suriano
authors.affiliation: Nutrition Services, VA Portland Health Care System, Portland, Oregon.
authors.forename: Marcelle
authors.initials: M
authors.lastname: Stooksbury
authors.affiliation: Palliative Care Service, Division of Internal Medicine, VA Portland Health Care System, Portland, Oregon.
authors.forename: Nora
authors.initials: N
authors.lastname: Tobin
authors.affiliation: Department of Head and Neck Surgery, MD Anderson Cancer Center, Houston, Texas.
authors.forename: Neil
authors.initials: N
authors.lastname: Gross
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Oregon Health & Science University and VA Portland Health Care System, Portland, Oregon.
authors.forename: Daniel
authors.identifier: 0000-0002-3296-4926
authors.initials: D
authors.lastname: Clayburgh
mesh_terms: D000368:Aged; D000553:Ambulatory Care / Q000458:organization & administration*; D000554:Ambulatory Care Facilities / Q000458:organization & administration; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D059248:Chemoradiotherapy / Q000379:methods*; D015331:Cohort Studies; D016001:Confidence Intervals; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D009959:Oropharyngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D017063:Outcome Assessment, Health Care; D010348:Patient Care Team / Q000458:organization & administration*; D011379:Prognosis; D058996:Quality Improvement; D012189:Retrospective Studies; D018570:Risk Assessment; D000077195:Squamous Cell Carcinoma of Head and Neck; D016019:Survival Analysis; D016896:Treatment Outcome; D014481:United States; D014728:Veterans
keywords: multidisciplinary care; oropharyngeal squamous cell carcinoma; survival; treatment outcomes