Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2019

Population-wide review of head and neck cancer treatment and mortality; Queensland experience (#250)

Sandro Porceddu 1 2 , Theresa Negrello 3 , Nathan Dunn 3 , Danica Cossio 3
  1. The Princess Alexandra Hospital, Queensland Health, Brisbane, Queensland, Australia
  2. Head and Neck Cancer Sub-committee, Queensland Cancer Control Safety and Quality Partnership, Queensland Health, Brisbane, Queensland, Australia
  3. Queensland Cancer Control Analysis Team, Queensland Health, Brisbane, QLD, Australia

Aims:

The Queensland Oncology Repository (QOR) collates and matches patient-level administrative and clinical data with the Queensland Cancer Register. We sought to provide the first population-wide review of head and neck cancer (HNC), treatment utilisation and mortality in Queensland between 2011 and 2015.

Methods

Data sourced from QOR included public and private hospital admissions, pathology, radiology, treatment and mortality for patients diagnosed with HNC between 2011 and 2015. HNC surgical procedural codes were determined under guidance of clinical specialists.  90-day mortality was defined as death within 90 days of surgery.  30-day mortality was defined as death within 30 days of last IV systemic therapy (IVST) or radiotherapy.

Results:

A total of 3,644 patients with HNC were identified, with the most common cancer sites being oropharynx for men and oral cavity for women. Surgery rates varied across primary sites, with highest rates observed for major salivary gland (91%), followed by oral cavity (79%), nasal cavity and paranasal sinuses (64%), and laryngeal cancers (59%).

Radiation therapy was common for cancers of the oropharynx, nasopharynx, and hypopharynx; 81%, 77% and 77%, respectively. Treatment with IVST was more common for cancers of the nasopharynx (73%) and oropharynx (70%).

Eighty percent of HNC patients were reviewed by a multidisciplinary team.  Treatment rates were higher among those reviewed (93%) comparted to those who were not (76%) [p<0.001].

Overall post-surgery 90-day mortality was 1.5%.  Queensland 90-day mortality varies across cancer types with 0.2% for breast cancer and 6.1% for oesophagogastric cancer1.  Of the HNC mortality was highest for hypopharyngeal cancers at 4.0%.  Death within 30 days of either radiation therapy or IVST was 8.7%.

Conclusions:

This study provides the first contemporary comprehensive population-wide review of HNC and sets a reference point to enable ongoing monitoring of HNC care in Queensland and Australia.

 

  1. 1Queensland Government. Queensland Cancer Quality Index: Indicators of safe, quality cancer care. Cancer care in Public and Private Hospitals 2005-2014. Queensland Health, Brisbane, 2017