Evidence map›Paper›PMID 41943401›Full record

ArticleHead & neck2026

Colocated Multidisciplinary Clinic Is Associated With Improved Timeliness to Postoperative Adjuvant Therapy in Head and Neck Cancer Patients.

Georges E Daoud, Melissa F Riedel, Martha J Ryan, Mokshad Gaonkar, Mitesh P Mehta, Kevin T Hendler, William A Stokes, James E Bates, Jill Remick, Dong M Shin and 11 more

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Article in Head & neck, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Georges E DaoudDepartment of Otolaryngology-Head and Neck Surgery, Winship Cancer Institute of Emory University, Atlanta, Georgia, USA.
Melissa F RiedelDepartment of Otolaryngology-Head and Neck Surgery, Winship Cancer Institute of Emory University, Atlanta, Georgia, USA.
Martha J RyanDepartment of Otolaryngology-Head and Neck Surgery, Winship Cancer Institute of Emory University, Atlanta, Georgia, USA.
Mokshad GaonkarDepartment of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia, USA.
Mitesh P MehtaDepartment of Otolaryngology-Head and Neck Surgery, Winship Cancer Institute of Emory University, Atlanta, Georgia, USA.
Kevin T HendlerDepartment of Otolaryngology-Head and Neck Surgery, Winship Cancer Institute of Emory University, Atlanta, Georgia, USA.
William A StokesDepartment of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia, USA.
James E BatesDepartment of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia, USA.
Jill RemickDepartment of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia, USA.
Dong M ShinDepartment of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia, USA.
Conor E SteuerDepartment of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia, USA.
Nabil F SabaDepartment of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia, USA.ORCID https://orcid.org/0000-0003-4972-1477
Mark W El-DeiryDepartment of Otolaryngology-Head and Neck Surgery, Winship Cancer Institute of Emory University, Atlanta, Georgia, USA.
Peter W KahngDepartment of Otolaryngology-Head and Neck Surgery, Winship Cancer Institute of Emory University, Atlanta, Georgia, USA.
Jennifer H GrossDepartment of Otolaryngology-Head and Neck Surgery, Winship Cancer Institute of Emory University, Atlanta, Georgia, USA.
Harry M BaddourDepartment of Otolaryngology-Head and Neck Surgery, Winship Cancer Institute of Emory University, Atlanta, Georgia, USA.ORCID https://orcid.org/0000-0001-6330-1458
Nicole C SchmittDepartment of Otolaryngology-Head and Neck Surgery, Winship Cancer Institute of Emory University, Atlanta, Georgia, USA.ORCID https://orcid.org/0000-0002-0571-3531
Azeem S KakaDepartment of Otolaryngology-Head and Neck Surgery, Winship Cancer Institute of Emory University, Atlanta, Georgia, USA.ORCID https://orcid.org/0000-0002-4528-4460
Mihir R PatelDepartment of Otolaryngology-Head and Neck Surgery, Winship Cancer Institute of Emory University, Atlanta, Georgia, USA.
Brian J BoyceDepartment of Otolaryngology-Head and Neck Surgery, Winship Cancer Institute of Emory University, Atlanta, Georgia, USA.
Soumon RudraDepartment of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDelays in postoperative adjuvant therapy, particularly PORT, have been shown to decrease survival, decrease oncologic locoregional control (LRC), and increase the risk of recurrence. Timely initiation of PORT, within 42 days of primary surgical resection, is recommended by the American College of Surgeons Commission on Cancer (CoC), but 55%-70% of patients do not meet this goal. We aimed to investigate whether our recent transition to a multidisciplinary care (MDC) model would have a significant impact on meeting this metric compared to our prior sequential care model, wherein patients see each cancer care provider at a separate visit.

methodsData were collected and retrospectively reviewed. Two cohorts were identified: pre-MDC initiation (November 2018-April 2019) and post-MDC initiation (September 2022-February May 2024). Our outcomes of interest included median time to adjuvant therapy, percent of patients who achieved timely adjuvant therapy initiation, defined as initiation within 6 weeks of primary surgical resection as recommended by the CoC guidelines, percentage of patients evaluated by a dentist in MDC, and percentage of patients who completed intraoperative dental extractions.

resultsOne hundred fifty-seven patients met inclusion criteria and baseline characteristics were statistically similar between the two cohorts. Postoperative delays were common in the pre-MDC cohort (69.6%, 32/46) compared with the post-MDC cohort (47.7%, 53/111) associated with 2.5-fold higher odds of delay (OR 2.50, 95% CI [1.20-5.18]; p = 0.013). Accordingly, the median time to PORT/POCRT was longer in the pre-MDC cohort (49 days) compared to the post-MDC cohort (43 days; p = 0.003). The post-MDC era was associated with a significantly faster time to adjuvant therapy initiation (HR 2.44, 95% CI [1.52-3.92]; p < 0.001). Thus, a greater proportion of patients in the post-MDC cohort (49.5%, 55/111) met the CoC guideline criteria compared with the pre-MDC cohort (28.3%, 13/46; OR 4.13, 95% CI [1.45-11.78]; p = 0.008). We also analyzed patients in two sub-cohorts in our post-MDC period; post-MDCND (no reliable dental evaluation in MDC) and post-MDCD (with reliable addition of a dentist in MDC). In the post-MDCD group, patients were more likely to be evaluated by a dentist (78.6% (44/56) vs. 38.2% (21/55), p < 0.001) and more likely to complete recommended intraoperative dental extractions at the time of primary surgical resection (100% (7/7) vs. 50.0% (6/12), p < 0.05) when compared with the post-MDCND cohort.

conclusionPatients seen in the post-MDC era were associated with an almost two and a half times more likely chance to start PORT/POCRT on time and were observed to have a fourfold better adherence to the CoC guidelines for timely adjuvant therapy initiation than those in the pre-MDC era. A colocated MDC may have enabled improved care coordination by helping to streamline communication, prophylactically identifying and mitigating potential delays in care, and developing comprehensive treatment plans that may have helped to improve timely adjuvant care.

Indexed as

Head and Neck NeoplasmsPatient Care TeamTime-to-TreatmentAgedChemotherapy, AdjuvantCohort StudiesFemaleHumansMaleMiddle AgedPostoperative CareRadiotherapy, AdjuvantRetrospective StudiesTime FactorsTreatment Delayadjuvant therapyhead and neck cancermultidisciplinary clinicpostoperative radiation therapy

Identifiers

PMID41943401
PMCPMC13432171

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.