Effects of multidisciplinary care on the survival of patients with oral cavity cancer in Taiwan.

OBJECTIVES The incidence of oral cavity cancer is high in Taiwan. To improve patient survival, multidisciplinary team (MDT) care was implemented. This research compared the survival of MDT care participants/non-participants and examined the effect of MDT care on patient characteristics. MATERIALS AND METHODS In this study, 19,513 patients with newly diagnosed oral cavity cancer were recruited from 2004 to 2007 in Taiwan. Matching based on the propensity of receiving MDT care was used. In total, 9297 patients were observed until 2008. A Cox proportional hazards model was applied to elucidate the relative risks of death. RESULTS The relative risk of death was lower for patients with MDT care than for those without such care (HR=0.84; 95% CI=0.78-0.90). Males had a higher risk of death than females (HR=1.20; 95% CI=1.04-1.38). Older age, lower income, and more severe comorbidity were associated with a higher risk of death. The effect of MDT care was stronger for older patients than for younger patients. Patients treated in public hospitals had a 1.24-fold (95% CI=1.13-1.36) higher risk of death than patients treated in private hospitals. Patients treated in hospitals or by attending physicians with higher service volumes had a lower relative risk of death (HR=0.89 and 0.78, respectively). The effect of MDT care was strong among patients with less severe comorbidities and patients without catastrophic illnesses. CONCLUSION The relative risk of death was lower for MDT care participants. The effect of MDT care was stronger among older patients and patients with fewer comorbidities.