Analysis of the impact of surgical quality indicators on the survival of treated patients

• Grant number: 24/22552-0
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: February 01, 2025
• End date: January 31, 2026
• Field of knowledge: Health Sciences - Medicine - Surgery
• Principal Investigator: Luiz Paulo Kowalski
• Grantee: João Ricardo Signoretti Alexandre
• Host Institution: Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil

Abstract

In 2020, approximately 1.5 million people were diagnosed with head and neck cancer, resulting in around 500,000 deaths. Although immutable patient characteristics contribute significantly to this mortality, high-quality medical treatment, particularly the surgeon's role, can considerably reduce the number of deaths. Evidence indicates that the surgeon's experience and adherence to best surgical practices directly influence the occurrence of postoperative complications and long-term patient survival. Therefore, the adoption of surgical quality indicators, such as negative surgical margins, lymph node yield, and the time between surgery and the initiation of adjuvant therapy, is essential to optimize prognosis and the value delivered to patients. Objectives: To analyze the impact of surgical quality indicators on the survival of patients with head and neck cancer treated at the Instituto do Câncer do Estado de São Paulo (ICESP) between 2012 and 2019. Methods: A retrospective cohort study was conducted, including approximately five thousand patients who underwent head and neck surgery. Data were collected from electronic medical records and processed to include information such as surgical margins, lymph node yield, postoperative complications, use of adjuvant therapy, and the time between surgery and the initiation of adjuvant treatment. Statistical analysis of the data will be performed using univariate and multivariate logistic regression models. Model evaluation will be conducted through the area under the ROC curve (AUCROC), and survival curves will be compared using the Kaplan-Meier statistical test. Statistical significance will be considered for p-values < 0.05. It is expected that the results of this study will provide solid evidence on the importance of surgical quality indicators in improving the survival of patients with head and neck cancer, guiding clinical practices and health policies to optimize patient care and outcomes.