Department of Oncology, KU Leuven, Leuven, Belgium; Department of Gynecology, Antoni van Leeuwenhoek - Netherlands Cancer Institute, Amsterdam, the Netherlands.
Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, the Netherlands.
Eur J Cancer. 2022 Aug;171:13-21. doi: 10.1016/j.ejca.2022.04.040. Epub 2022 Jun 10.
Most physicians encounter pregnant women with cancer incidentally, leading to a lack of expertise or confidence to inform and treat these patients based on the most recent guidelines and expert opinions. In the Netherlands, a national multidisciplinary tumour board for cancer, infertility and pregnancy (CIP-MDT) was founded in December 2012, including 35 specialists from a variety of disciplines. This study evaluates the frequency of consultation of the CIP-MDT, the types of questions asked and the satisfaction of consulting physicians with its existence.
Of all requests to the CIP-MDT between December 2012 and June 2021, tumour type, stage, gestational age at diagnosis and recommendations were collected and analysed. For evaluating the methods of the CIP-MDT, a survey with questions regarding experiences with the CIP-MDT and its impact on treatment decisions was sent out to physicians that consulted the CIP-MDT.
Recommendations (n = 213) concerned preferred and safest options for imaging, treatment options during pregnancy, possible effects on the child and fertility preserving options. Most frequently discussed malignancies were breast cancer (n = 66), cervical cancer (n = 34), haematological malignancies (n = 32) and melanoma (n = 21). The questionnaire was completed by 54% of the physicians (n = 50). Satisfaction with the recommendations of the CIP-MDT was high, and 94% of the physicians informed their patients about consulting the CIP-MDT and felt supported by the received recommendations.
The national Dutch CIP-MDT contributes to a high level of satisfaction among physicians requesting advice. Further research should be executed to confirm that a CIP-MDT improves the outcomes for pregnant women and their children.
大多数医生都是偶然遇到癌症孕妇的,因此缺乏根据最新指南和专家意见为这些患者提供信息和治疗的专业知识或信心。荷兰于 2012 年 12 月成立了一个多学科肿瘤委员会,用于癌症、不孕和妊娠(CIP-MDT),该委员会包括来自多个学科的 35 名专家。本研究评估了 CIP-MDT 的咨询频率、提出的问题类型以及咨询医生对其存在的满意度。
收集并分析了 2012 年 12 月至 2021 年 6 月间向 CIP-MDT 提出的所有请求,包括肿瘤类型、分期、诊断时的孕龄以及建议。为了评估 CIP-MDT 的方法,向咨询过 CIP-MDT 的医生发送了一份关于他们对 CIP-MDT 的体验及其对治疗决策的影响的调查问题。
(n=213)建议涉及影像学的首选和最安全选择、妊娠期间的治疗选择、对孩子的可能影响以及保留生育能力的选择。讨论最多的恶性肿瘤是乳腺癌(n=66)、宫颈癌(n=34)、血液恶性肿瘤(n=32)和黑色素瘤(n=21)。调查问卷由 54%的医生(n=50)完成。医生对 CIP-MDT 建议的满意度很高,94%的医生告知了他们的患者咨询了 CIP-MDT,并对收到的建议感到支持。
荷兰全国性的 CIP-MDT 提高了请求咨询的医生的满意度。应进一步开展研究以确认 CIP-MDT 是否能改善孕妇及其子女的预后。