Background

For patient with head & neck cancer, control of loco-regional disease is key. Recurrent disease may be curable, but at considerable cost. At present, national audits of H&N cancer can report overall survival, but not relapse rates¹. At a national level, there are routinely collected data on hospital admissions, radiotherapy and chemotherapy (via HES, RTDS and SACT). We conducted a pilot study to evaluate the use of routinely collected healthcare data to describe patterns of treatment in H&N cancer patients.

Method

We identified 7 patients at high risk of recurrence from local MDT lists and extracted a record of their treatment from hospital notes. We obtained a combination of local HES, SACT and RTDS data on the same patients, and assessed our approach by measuring comparative identification of key healthcare events and time-to-event data.

Results

All 7 patients had primary squamous cell carcinoma of the oropharynx or oral cavity, and all received radical treatment. In 6 cases, this was with chemo-radiotherapy; 1 had primary radical surgery. 4 patients had further radical/adjuvant treatment for residual disease or close surgical margins. 1 had no further treatment and 2 had further palliative treatment. The four patients who had further radical/ adjuvant treatment, and the 1 who had no further treatment, were all correctly identified using routine data. Only 1 of the 2 patients who had subsequent palliative treatment were correctly identified. The estimates provided by the routine data for event-free survival were within 0.85 - 1.15 of the actual figure for 3 of the 5 patients.

Conclusion

We have developed a method of assessing clinically relevant outcomes for patients with H&N cancers using routinely collected data. This small pilot study demonstrates that in radically treated patients it accurately captures patterns of initial and subsequent care.