Complex head and neck cancer surgery specialist centres NSW
Criteria for a specialist complex head and neck cancer centre
A resection is surgery to remove the cancer from the head and neck area. Some of these operations can be very complex, and require a team of health care professionals with suitable experience performing this surgery and providing supportive care after surgery.[1]
Complex surgery includes the following three procedures; radial neck dissection, free flap and radical neck dissection and free flap.[1]
International studies indicate that patient outcomes can be improved when complex head and neck cancer surgery is performed in centres that do a high number of these procedures.[2,3]
It is recommended that specialist centres for complex head and neck cancer perform 25 resections per year*
* This minimum suggested annual surgical caseload has been selected through a clinical advisory group process bringing together international evidence and expert consensus.
Multidisciplinary cancer care team
Patients with head and neck cancer may have one or more types of treatment, including surgery, chemotherapy, radiotherapy and targeted therapies.
The involvement of a multidisciplinary cancer care team is required. This team brings together health care professionals from different specialties to discuss a patient’s cancer diagnosis and staging, and their treatment options. It also enhances communication and care co-ordination between the specialists involved in a patient’s care.
Australian and international studies state that patients overseen by a multidisciplinary cancer care team experience better outcomes after cancer treatment.[4–to5]
Team members
The core members of a multidisciplinary cancer care team for complex head and neck cancers have been validated by the Head and Neck Cancer Clinical Advisory Group. These core members are:
- Head and neck surgeon
- ENT surgeon
- General surgeon
- Maxillofacial surgeon
- Plastic and reconstructive surgeon
- Medical oncologist
- Radiation oncologist
- Palliative care clinician
- Pathologist
- Radiologist/imaging specialist
- Special needs dentist
- Specialist nurse
- Speech pathologist
- Dietitian
- Psychosocial support (liaison with psychologist or social worke
Actions for Health Professionals
Patient referral
Patients with a suspected or confirmed head and neck cancer should be referred to a specialist who is a member of a multidisciplinary cancer care team, and practices at one of the specialist centres listed below.
Involvement of a multidisciplinary cancer care team early in the cancer journey is recommended to ensure optimal assessment, care, and outcomes.
The Canrefer website allows you to find cancer specialists who are MDT members, and has information about cancer services, optimal care pathways, and patient resources.
Smoking cessation support
Evidence suggests that tobacco cessation following cancer diagnosis improves survival. It also reduces treatment-related complications.[6-7] Health professionals should discuss tobacco use with all patients and provide appropriate cessation support.
List of public specialist centres for complex head and neck cancer surgery
| Local health district | Hospital | Annual average complex head and neck resection caseloadJan 2021 - Dec 2022 | Multidisciplinary cancer care team |
|---|---|---|---|
Hunter New England | John Hunter Hospital | 51-100 | Hunter New England Head and Neck Cancer MDT |
| Northern Sydney | Royal North Shore | 51-100 | Royal North Shore Hospital Head and Neck Cancer MDT |
| St Vincent's Health Network | St Vincents Hospital, Darlinghurst | 51-100 | The Kinghorn Cancer Centre Head and Neck Cancer MDT |
| South Western Sydney | Liverpool | 25-50 | Liverpool-Macarthur Cancer Therapy Centre Head and Neck Cancer MDT |
| Western Sydney | Westmead | 25-50 | Western Sydney Local Health District Head and Neck Cancer MDT |
| South Eastern Sydney | Prince of Wales | 25-50 | Prince of Wales Head and Neck Cancer MDT |
| Illawarra Shoalhaven | Wollongong | 25-50 | Illawarra Shoalhaven Local Health District Head and Neck Cancer MDT |
| Nepean Blue Mountains | Nepean | 25-50 | Western Sydney Local Health District Head and Neck Cancer MDT |
List of private specialist centres for complex head and neck cancer surgery
| Local health district | Hospital | Annual average complex head and neck resection caseload Jul 2020 - Jun 2022 | Multidisciplinary cancer care team |
|---|---|---|---|
Sydney | Chris O'Brien Lifehouse | 150-200 | Royal Prince Alfred and Lifehouse Head and Neck Cancer MDT |
South Eastern Sydney | St Vincent's Private Hospital, Darlinghurst | 50-100 | The Kinghorn Cancer Centre Head and Neck Cancer MDT |
| Western Sydney | Westmead Private Hospital | 25-50 | Western Sydney Local Health District Head and Neck Cancer MDT |
Codes
- Surgical caseload data sourced from Admitted Patient, Emergency Department Attendance, and Deaths Register (APEDDR) via Secure Analytics for Population Health Research and Intelligence (SAPHaRI), Centre for Epidemiology and Evidence, NSW Ministry of Health.
- In-scope diagnoses: primary head and neck (C00.0–10.2, C10.4, C10.8, C10.9, C11-14, C15.3, C30.0, C31.0, C31.1, C32-33, C43.1-43.4, C44.0- 44.4)
- In-scope procedures: 39700-00,39640-00,39642-00,39646-00,39650-00,41581-00,42543-00,42539-00,41545-00,41548-00,41728-00,41779-01,30247-00,30250-00,30255-00,30259-00,90138-00,30275-00,41782-00,41785-00,41785-01,41834-00,41837-00,41840-00,41843-00,30294-01,38453-00,38453-02,34148-00,34151-00,34154-00,31423-01,31435-00,96244-01,96245-01,30294-00,45863-00,45873-00,45562-00,45562-01,45599-0045602-00,45605-00,45611-00,45755-00,52120-00,455960,45597-00,45602-01,45605-01,90679-00,90679-01,90679-02,90679-03,90680-00,90680-01,90680-02,90680-03,45720-00,45720-01,45720-02,45720-03,45726-00,45726-01,45726-02,45726-03,45723-00,45723-01,45723-02,45723-03,45729-00,45729-01,45729-02,45729-03,45731-00,45731-01,45735-00,45741-00,45747-00,45732-00,45732-01,45738-00,45744-00,45752-00,45753-00,45754-00,41584-00,41587-00
References
- Pfister DG, Spencer S, Adelstein D, Adkins D, Anzai Y, Brizel DM, et al. Head and neck cancers, version 2.2020, NCCN clinical practice guidelines in oncology. Journal of the National Comprehensive Cancer Network. 2020;18(7):873-98
- Madrigal J, Mukdad L, Han AY, Tran Z, Benharash P, St. John MA, et al. Impact of hospital volume on outcomes following head and neck cancer surgery and flap reconstruction. The Laryngoscope. 2022;132(7):1381-7.
- Schmitt NC, Ryan M, Halle T, Sherrod A, Wadsworth JT, Patel MR, et al. Team-Based Surgical Scheduling for Improved Patient Access in a High-Volume, Tertiary Head and Neck Cancer Center. Annals of Surgical Oncology. 2022;29(11):7002-6.
- Shang C, Feng L, Gu Y, Hong H, Hong L, Hou J. Impact of multidisciplinary team management on the survival rate of head and neck cancer patients: a cohort study meta-analysis. Frontiers in Oncology. 2021;11:630906.
- Taberna M, Gil Moncayo F, Jané-Salas E, Antonio M, Arribas L, Vilajosana E, et al. The multidisciplinary team (MDT) approach and quality of care. Frontiers in oncology. 2020;10:85.
- Jassem J. Tobacco smoking after diagnosis of cancer: clinical aspects. Translational lung cancer research. 2019;8(Suppl 1):S50.
- Warren GW, Alberg AJ, Cummings KM, Dresler C. Smoking cessation after a cancer diagnosis is associated with improved survival. Journal of Thoracic Oncology. 2020;15(5):705-8.
