Regionalization of Health Care in Head and Neck Cancer: Concept and Considerations.

Abstract

Introduction: Head and neck cancer are rare and require complex medical and surgical management. Regionalization or centralization of care, defined as the concentration of patients with complex diseases from a specific area in institutions with more experienced and highly functional multidisciplinary teams, may be an alternative to achieve better oncologic outcomes.

Objective: To systematize the current knowledge regarding the centralization of care in head and neck oncology and its consequences in the practice of related surgeries.

Data synthesis: Currently, there is evidence that this strategy shows better oncologic outcomes in centers with greater volumes, greater adherence to evidence-based clinical guidelines and quality indicators, and a multidisciplinary team in charge of decision-making. The center in Ontario, Canada, is framed as an example of this strategy, achieving improved outcomes while maintaining a high level of quality.

Conclusion: Although more high-quality studies are needed to support this strategy, we believe that the evidence already available is sufficient to consider it a valid option to improve the oncologic outcomes of patients.