Multidisciplinary care in head and neck squamous cell carcinoma: A retrospective analysis at a safety-net hospital.

Abstract

e18117 Background: Optimal HNSCC management requires coordinated multidisciplinary care including dental evaluation, nutrition support, speech-language pathology (SLP), and audiology. National guidelines recommend early integration of supportive services, but adherence in real-world safety-net settings is variable. We evaluated patterns of multidisciplinary involvement and supportive care utilization. Methods: A retrospective chart review was conducted on 58 patients with HNSCC treated curatively from 2019–2024. Data collected included utilization and timing of dental evaluation, SLP, nutrition, audiology, and percutaneous endoscopic gastrostomy (PEG) tube placement. Weight change from diagnosis through treatment and at 6 months post-treatment was assessed as a marker of nutritional impact. Results: Pre-treatment dental evaluation occurred in 62.5% of evaluable patients. SLP evaluation occurred in 43.9% pre-treatment, with 22.8% receiving ongoing follow-up. Nutrition evaluation occurred in 66.7% pre-treatment, with 43.9% receiving continued follow-up. Audiology evaluation was rare (4.0%). Forty-nine patients were eligible for PEG tube placement; nine deferred or declined. Patients with pre-treatment nutrition evaluation experienced less weight loss during treatment (8.7 kg vs 10.8 kg) and at 6 months post-treatment (11.8 kg vs 14.1 kg). Year-to-year rates of pre-treatment multidisciplinary evaluation varied without consistent improvement. Conclusions: Multidisciplinary supportive care utilization varied among patients with HNSCC in this population. Early nutrition evaluation was associated with less treatment-related weight loss. These findings support efforts to standardize multidisciplinary pathways and optimize supportive care integration during curative-intent treatment.