APPENDIX: Supplementary Table I.
Evidence of the recommendations evaluated by the developed indicators.
| Indicator code |
Description Proportion of patients having an: |
Recommendation | Evidence type and strength (grade) |
|---|---|---|---|
| S1 | Interval between cyto-histological assessment and surgery as the first treatment ≤ 60 days | Cancer care needs to be timel 1 | Meta-analysis 2 Moderate |
| S4 | Interval between cyto-histological assessment and CT as the first treatment ≤ 60 days | ||
| S2 | Interval between cyto-histological assessment and RT as the first treatment ≤ 60 days | Cancer care needs to be timely 1 | Meta-analysis 3 Strong |
| S3 | Interval between discharge from primary surgery and postoperative RT ≤ 60 days | Time between surgery and start of radiotherapy should be less than 6 weeks 4 | Observational studies 5,6 Week |
| D1 | Having performed a cyto-histological assessment of the primary tumor in the 180 days before the first treatment |
A clinically suspected diagnosis of malignancy should be confirmed by biopsy or cytology before operation 7 | No specific studies Week |
| D2 | With distant metastasis risk tumor type undergoing systemic staging with PET-CT or whole body computed tomography | Offer systemic staging to all people with cancer of the upper aerodigestive tract except those with T1N0 or T2N0 disease. Offer FDG PET-CT to people with T4 cancer of the hypopharynx or nasopharynx. Offer FDG PET-CT to people with N3 cancer of the upper aerodigestive tract 8 |
RCTs and observationals 8 High |
| T1 | Deceased in perioperative period (≤ 15 days from surgery) | Used as a proxy for adequate pre-surgical evaluation and quality of surgery 9 |
Expert opinion 10 Week |
| T2 | With a second hospital access ≤ 3 days from discharge for primary surgery | Used as a proxy for adequate pre-surgical evaluation and quality of surgery 11,12 |
Observational studies 13 Week |
| T3 | Treated with IMRT | IMRT therapy is recommended for pharyngeal cancer 4 |
Observational studies 14,15 Week |
| T4 | Deceased and evaluated by pain therapist, under opioids or hospitalized for palliation in the 90 days before | Patients with advanced cancer, whether patient or outpatient, should receive dedicated palliative care services, early in the disease course, concurrent with active treatment 16 |
Systematic review 17 Strong |