van Rijssen Lennart B, van der Geest Lydia G M, Bollen Thomas L, Bruno Marco J, van der Gaast Ate, Veerbeek Laetitia, Ten Kate Fibo J W, Busch Olivier R C
Dutch Pancreatic Cancer Group (DPCG), The Netherlands; Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
Dutch Pancreatic Cancer Group (DPCG), The Netherlands; Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.
Pancreatology. 2016 Jan-Feb;16(1):133-7. doi: 10.1016/j.pan.2015.10.002. Epub 2015 Oct 26.
We evaluated national compliance to selected quality indicators from the Dutch multidisciplinary evidence-based guideline on pancreatic and periampullary carcinoma and identified areas for improvement.
Compliance to 3 selected quality indicators from the guideline was evaluated before and after implementation of the guideline in 2011: 1) adjuvant chemotherapy after tumor resection for pancreatic carcinoma, 2) discussion of the patient within a multidisciplinary team (MDT) meeting and 3) a maximum 3-week interval between final MDT meeting and start of treatment.
In total 5086 patients with pancreatic or periampullary carcinoma were included. In 2010, 2522 patients were included and in 2012, 2564 patients. 1) Use of adjuvant chemotherapy following resection for pancreatic carcinoma increased significantly from 45% (120 out of 268) in 2010 to 54% (182 out of 336) in 2012 which was mainly caused by an increase in patients aged <75 years. 2) In 2012, 64% (896 of 1396) of patients suspected of a pancreatic or periampullary carcinoma was discussed within a MDT meeting which was higher in patients aged <75 years and patients starting treatment with curative intent. 3) In 2012, the recommended 3 weeks between final MDT meeting and start of treatment was met in 39% (141 of 363) of patients which was not influenced by patient and tumor characteristics.
Compliance to three selected quality indicators in pancreatic cancer care was low in 2012. Areas for improvement were identified. Future compliance will be investigated through structured audit and feedback from the Dutch Pancreatic Cancer Audit.
我们评估了荷兰关于胰腺癌和壶腹周围癌的多学科循证指南中选定质量指标的全国依从性，并确定了有待改进的领域。
在2011年指南实施前后，对指南中选定的3项质量指标的依从性进行了评估：1）胰腺癌肿瘤切除术后的辅助化疗；2）在多学科团队（MDT）会议上对患者进行讨论；3）MDT最终会议与开始治疗之间的间隔最长为3周。
共纳入5086例胰腺癌或壶腹周围癌患者。2010年纳入2522例患者，2012年纳入2564例患者。1）胰腺癌切除术后辅助化疗的使用率从2010年的45%（268例中的120例）显著增加到2012年的54%（336例中的182例），这主要是由于年龄<75岁的患者数量增加。2）2012年，1396例疑似胰腺癌或壶腹周围癌的患者中有64%（896例）在MDT会议上进行了讨论，年龄<75岁的患者以及开始进行根治性治疗的患者中这一比例更高。3）2012年，363例患者中有39%（141例）在MDT最终会议与开始治疗之间达到了推荐的3周间隔，这不受患者和肿瘤特征的影响。
2012年胰腺癌护理中对选定的三项质量指标的依从性较低。确定了有待改进的领域。未来将通过荷兰胰腺癌审计的结构化审核和反馈来调查依从性情况。
