What is necessary to equalize the quality of head and neck cancer management?:From the treatment outcome of oropharyngeal, hypopharyngeal and laryngeal cancer patients in a rural hospital

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We investigated head and neck cancer cases treated in our hospital from April of 2006 to March of 2011, from the perspective of equalization in the quality of head and neck cancer management. Most of the oropharyngeal, hypopharyngeal and laryngeal cancer patients were treated with chemo-radiation therapy. The outcome of the patient group, including disease-specific survival rate and laryngeal preservation rate, were calculated. In addition, we tallied the numbers of oral, pharyngeal and laryngeal cancer cases from each hospital using the annual report of domestic cancer registry of Japan 2008.We found that of the total number of 139 cases treated with the intention of curing the disease, 36 were advanced oropharyngeal, hypopharyngeal and laryngeal cancer patients (Stage III and IV), and their disease-specific, 3-year survival rate was 70%, while the laryngeal preservation (excluding oropharyngeal cancer) rate was 58%.Among the 218 hospitals with registered oral, pharyngeal and laryngeal cancer cases, 121 hospitals registered less than 40 cases. This fact indicates there are many rural hospitals, which treat a relatively small number of patients, and equalization of the quality of head and neck cancer management is considered an urgent task.