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丹麦头颈部癌症快速通道项目:一家三级癌症中心的经验。

The Danish Head and Neck Cancer fast-track program: a tertiary cancer centre experience.

机构信息

Department of ORL-Head & Neck Surgery, Odense University Hospital, J. B. Winsløws Vej 4, 5000 Odense C, Denmark.

Department of ORL-Head & Neck Surgery, Odense University Hospital, J. B. Winsløws Vej 4, 5000 Odense C, Denmark.

出版信息

Eur J Cancer. 2018 Feb;90:133-139. doi: 10.1016/j.ejca.2017.10.038. Epub 2017 Dec 19.

Abstract

INTRODUCTION

During the 1990s, all Nordic countries except for Denmark experienced a general increase in 5-year survival rates for cancer patients. In 2007, the Danish National Board of Health in collaboration with national multidisciplinary cancer groups and the Danish regions initiated fast-track clinical pathway solutions.

OBJECTIVES

The objectives of this study were 1) to present the setup of the head and neck cancer (HNC) fast-track program at Odense University Hospital (OUH) as an example of the Danish model and 2) to present patient characteristics, diagnostic outcome, cancer detection rate, and duration of the fast-track patient courses.

MATERIALS AND METHODS

From 1st July 2012 to 1st September 2015, all patients referred to the HNC fast-track program at OUH for diagnostics and treatment were consecutively included in the study resulting in 3165 patient courses.

RESULTS

The overall malignancy detection rate was 40.6% and for HNC it was 29.2%. The overall median fast-track course duration was 12 days (range 0-74). Overall 2990 (94.5%) of 3165 patients completed their fast-track course within the maximally permitted course duration.

DISCUSSION AND CONCLUSION

Based on our findings, it was concluded that: 1) a HNC fast-track program build on pre-booked slots for diagnostics and treatment is feasible and can secure acceptable course durations for more than 90% of patient courses, 2) by using private ENT specialists as a 'filter-function', an acceptable detection rate can be achieved.

摘要

简介

20 世纪 90 年代,北欧除丹麦以外的所有国家的癌症患者 5 年生存率均普遍提高。2007 年,丹麦国家卫生局与国家多学科癌症小组和丹麦地区合作,启动了快速通道临床路径解决方案。

目的

本研究的目的是 1)以丹麦模式为例,介绍奥胡斯大学医院(OUH)头颈部癌症(HNC)快速通道项目的设置;2)介绍患者特征、诊断结果、癌症检出率和快速通道患者治疗过程的持续时间。

材料和方法

从 2012 年 7 月 1 日至 2015 年 9 月 1 日,所有转诊到 OUH 的 HNC 快速通道计划进行诊断和治疗的患者均连续纳入研究,共纳入 3165 例患者。

结果

总体恶性肿瘤检出率为 40.6%,HNC 为 29.2%。快速通道治疗过程的中位数总持续时间为 12 天(范围 0-74 天)。总体而言,3165 例患者中有 2990 例(94.5%)在允许的最长治疗过程时间内完成了快速通道治疗过程。

讨论与结论

基于我们的发现,得出以下结论:1)建立在预先预订诊断和治疗时段基础上的 HNC 快速通道计划是可行的,能够确保超过 90%的患者治疗过程持续时间可接受;2)通过使用私人耳鼻喉科专家作为“筛选功能”,可以实现可接受的检出率。

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