Atwell Daisy, Vignarajah Dinesh D, Chan Bryan A, Buddle Nicole, Manders Peter M, West Katrina, Knesl Marcel, Long Jeremy, Min Myo
Department of Radiation Oncology, Sunshine Coast University Hospital, Birtinya, Queensland, Australia.
Icon Radiation Oncology Centre, Maroochydore, Queensland, Australia.
J Med Imaging Radiat Oncol. 2019 Jun;63(3):378-382. doi: 10.1111/1754-9485.12851. Epub 2019 Jan 8.
The multidisciplinary team meeting (MDTM) approach is accepted as standard of care to optimise treatment for patients diagnosed with cancer. This retrospective audit reviews the proportion of patients whose care is being discussed at cancer MDTMs within the Sunshine Coast Hospital and Health Service (SCHHS).
Patients included were those diagnosed with cancer within the SCHHS between 2010 and 2015, and subsequently referred to a public MDTM for discussion. Data were extracted from the Queensland Cancer Control Analysis Team (QCCAT) database regarding the incidence of breast, lung, upper gastrointestinal (GI), colorectal, genitourinary and malignant haematological cancers and the number of patients referred to the corresponding MDTM.
Data from 2015 show referral rates to MDTMs as follows: lung 100%, upper gastrointestinal 100%, colorectal 64%, breast 60%, malignant haematology 40% and genitourinary 28%. Of the genitourinary presentations, 70% were prostate cases and 14% bladder cases. Review of genitourinary MDTM outcomes found that, of the patients with prostate cancer discussed, 30% were metastatic, 19% were poor surgical candidates and 15% had biochemical recurrence.
This audit demonstrates variable utilisation of MDTMs between tumour streams. Our study shows a high and increasing referral rate to all tumour stream MDTMs except for genitourinary. This suggests a possible underutilisation of genitourinary MDTMs to discuss treatment options for patients with genitourinary cancer. Collaborative research is warranted to further investigate whether this is a local or widespread issue.
多学科团队会议(MDTM)方法被公认为优化癌症确诊患者治疗的护理标准。本次回顾性审计审查了阳光海岸医院及健康服务中心(SCHHS)内癌症多学科团队会议上讨论护理的患者比例。
纳入的患者为2010年至2015年间在SCHHS被诊断为癌症,随后被转诊至公共多学科团队会议进行讨论的患者。从昆士兰癌症控制分析团队(QCCAT)数据库中提取了有关乳腺癌、肺癌、上消化道(GI)癌、结直肠癌、泌尿生殖系统癌和恶性血液系统癌的发病率以及转诊至相应多学科团队会议的患者数量的数据。
2015年的数据显示转诊至多学科团队会议的比例如下:肺癌100%,上消化道癌100%,结直肠癌64%,乳腺癌60%,恶性血液学40%,泌尿生殖系统28%。在泌尿生殖系统病例中,70%为前列腺病例,14%为膀胱病例。对泌尿生殖系统多学科团队会议结果的审查发现,在讨论的前列腺癌患者中,30%为转移性患者,19%为手术不佳候选人,15%有生化复发。
本次审计表明不同肿瘤类型对多学科团队会议的利用情况存在差异。我们的研究表明,除泌尿生殖系统外,所有肿瘤类型多学科团队会议的转诊率都很高且呈上升趋势。这表明泌尿生殖系统多学科团队会议在讨论泌尿生殖系统癌症患者治疗方案方面可能未得到充分利用。有必要开展合作研究,进一步调查这是局部问题还是普遍问题。