Department of Gynaecological Oncology, Faculty of Medical and Health Sciences, Auckland City Hospital, Auckland, New Zealand.
Int J Gynecol Cancer. 2009 Dec;19(9):1470-2. doi: 10.1111/IGC.0b013e3181bf82df.
To assess the role of the multidisciplinary tumor conference in patient management in a tertiary gynecologic oncology service.
Data were analyzed from the records of all patients presented at the gynecologic oncology tumor conferences at Auckland City Hospital from August 1, 2005, to August 1, 2006. Patient information including referral source, cancer site, stage, whether surgery had been performed before the tumor conference and if so where and by whom, and benign versus malignant was extracted from the records. The radiological and pathological findings and diagnosis for each patient both before and after each tumor conference were compared. A discrepancy was defined as a change in tumor site, histological type, grade, or stage that resulted from findings discussed at the conferences. Diagnostic discrepancies that resulted in a change in patient management were classified as major discrepancies. Discrepancies that did not affect patient management were classified as minor discrepancies.
A total of 509 cases were discussed during the study period. Forty-six discrepancies (9%) were noted, with 30 major (5.9%) and 16 minor (3.1%) discrepancies. The most common changes to patient management that resulted from the tumor conferences were the addition of chemotherapy and surgery.
This study demonstrates that gynecologic oncology tumor conferences alter the diagnosis in a significant number of cases and therefore affect patient management.
评估多学科肿瘤会议在三级妇科肿瘤服务中对患者管理的作用。
对 2005 年 8 月 1 日至 2006 年 8 月 1 日期间在奥克兰市医院妇科肿瘤会议上展示的所有患者的记录进行数据分析。从记录中提取患者信息,包括转诊来源、癌症部位、分期、在肿瘤会议之前是否已进行手术,如果是,在哪里以及由谁进行的手术,以及良性与恶性。比较每位患者在每次肿瘤会议前后的放射学和病理学发现和诊断。将因会议上讨论的结果而导致肿瘤部位、组织学类型、分级或分期发生变化的情况定义为差异。导致患者管理发生变化的诊断差异被归类为主要差异。不会影响患者管理的差异被归类为次要差异。
在研究期间共讨论了 509 例病例。有 46 例差异(9%),其中 30 例主要差异(5.9%)和 16 例次要差异(3.1%)。肿瘤会议导致的患者管理最常见的变化是添加化疗和手术。
这项研究表明,妇科肿瘤肿瘤会议在大量病例中改变了诊断,从而影响了患者的管理。