Defining High-Quality Integrated Head and Neck Cancer Care Through a Composite Outcome Measure: Textbook Outcome

Laryngoscope. 2022 Jan;132(1):78-87. doi: 10.1002/lary.29720. Epub 2021 Jul 3.

Abstract

Objectives/hypothesis: To further improve the quality of head and neck cancer (HNC) care, we developed a composite measure defined as "textbook outcome" (TO).

Methods: We analyzed a retrospective cohort of patients after curvative-intent primary surgery, radiotherapy (RT), or chemoradiation (CRT) for HNC between 2015 and 2018 at the Netherlands Cancer Institute. TO was defined as 1) the start of treatment within 30 days, 2a) satisfactory pathologic outcomes, without 30-day postoperative complications, for the surgically treated group, and 2b), for RT and CRT patients, no unexpected or prolonged hospitalization and toxicity after the completion of treatment as planned.

Results: In total, 392 patients with HNC were included. An overall TO was achieved in 9.6% of patients after surgery, 20.6% after RT, and 2.2% after CRT. Two indicators (margins >5 mm and start treatment <30 days) reduced TO radically for both groups.

Conclusion: TO can aid the evaluation of the quality of care for HNC patients and guide improvement processes.

Level of evidence: 3 Laryngoscope, 132:78-87, 2022.

Keywords: Head and neck; outcomes; quality improvement.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Delivery of Health Care, Integrated / standards*
  • Female
  • Head and Neck Neoplasms / surgery
  • Head and Neck Neoplasms / therapy*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • Netherlands
  • Outcome Assessment, Health Care / standards*
  • Quality Improvement
  • Quality of Health Care / standards*
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult