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Team Decision-Making Improves Surgical Outcomes

Eugene N. Myers, MD International Lecture on Head and Neck Cancer

Sunday, October 4, 1:00 – 2:00 pm

Choosing the right surgeon, hospital, or surgical center could mean the difference between life or death for patients who have head and neck cancer.

Luiz P. Kowalski, MD

“Evidence suggests that surgeons and hospital volume and specialization play major roles in patient survival after initial or salvage head and neck cancer treatment,” said Luiz P. Kowalski, MD, PhD, chair of the Department of Head and Neck Surgery and Otorhinolaryngology at A.C. Camargo Cancer Center, and professor and chair of the Head and Neck Surgery Department at the University of São Paulo Medical School in Brazil.

“Hospital and surgeon volume are the benchmarks of quality care because of their significant impact on postoperative complications and overall survival,” said Dr. Kowalski. “However, these factors are not easily transferable, suggesting that the centralization of care in high-volume universities, research centers, and cancer centers can improve outcomes after head and neck cancer multidisciplinary treatment.”

Dr. Kowalski is this year’s honorary guest lecturer for the Eugene N. Myers, MD International Lecture on Head and Neck Cancer. During his lecture “Surgeon Is a Major Prognostic Factor of Head and Neck Cancer Patients Undergoing Primary and Salvage Surgery,” Dr. Kowalski will describe how selecting the optimal treatment strategy has grown in complexity, resulting in better outcomes for patients.

By the end of the 19th century, the survival rate in treated [surgery] patients was 10%. With the improvements in surgical techniques, currently about two-thirds of patients survive for more than five years.

“Teamwork and progress in surgical reconstruction have led to advancements in ablative surgery; the associated adjuvant treatments have further improved the prognosis in the last 30 years,” said Dr. Kowalski.

Even though surgical techniques have improved outcomes, the importance of other prognostic factors cannot be overlooked.

“Surgeons are aware that the influence of most tumor- and patient-related prognostic factors in head and neck cancer cannot be changed by medical interventions; however not all take in account that some environmental factors including treatment decision-making and quality can be modified and influence prognosis,” he said.

Treatment decision-making shouldn’t fall to a single expert, either.

“Currently, the burden of decision-making is shared among surgeons, medical oncologists, and radiation oncologists and usually is based on tumor- and patient-related factors as well as the expected rates of complications and tumor control. Furthermore, modern medical ethics emphasize the patient’s right to self-determination,” said Dr. Kowalski.

“Considering the current large amount of information, ideally, all treatment strategy decisions should not be taken by an individual surgeon, but must be taken at dedicated multidisciplinary team meetings,” he added. “It is teamwork.”

If you miss this live event, it will become available in the on-demand library of education content within 72 hours following the presentation.