Association of surgical quality metrics and hospital-level overall survival for patients with head and neck squamous cell carcinoma.

206Background: Both negative margins and lymph node yields ≥ 18 from neck dissections in patients with head and neck mucosal squamous cell carcinomas (SCC) have been correlated with improved overall survival. It is unclear whether these patient-level metrics are applicable at the hospital level, and what compliance rates hospitals would need to achieve to show an improvement in survival. Methods: The National Cancer Database (NCDB) was used to identify patients who underwent primary surgery that included a neck dissection for mucosal SCC of the oral cavity, oropharynx, larynx, and hypopharynx. The percentage of patients at each institution with negative margins on primary resection and lymph node yields ≥ 18 from a neck dissection was quantified. A multivariate Cox proportional hazard regression was used to determine the association between hospital compliance rates with these metrics and overall survival. Results: There were 65,097 patients at 1,087 hospitals in the NCDB who underwent a neck dissection f...