Effect of Initiating a Multidisciplinary Care Clinic on Access and Time to Treatment in Patients With Pancreatic Adenocarcinoma

Abstract

Purpose: Neoadjuvant therapy for pancreatic adenocarcinoma requires referral to multiple specialists before initiating therapy. We evaluated the effect of establishing a multidisciplinary clinic (MDC) for patients with newly diagnosed pancreatic adenocarcinoma on treatment access and time to therapy. Methods:Patients with newly diagnosed pancreatic adenocarcinoma diagnosed and treated at our center were included. Two patient groups were defined: preclinic represented those patients diagnosed before 2008 and MDC represented those patients diagnosed since 2009 who were treated in the newly created MDC and were initially candidates for neoadjuvant therapy. The primary outcomes were days from diagnosis to first treatment (initiation of chemotherapy or external beam radiation), days to completion of all required consultations, and number of visits needed before initiation of therapy.

Impact of a Single-Day Multidisciplinary Clinic on the Management of Patients with Liver Tumours

“…The importance of coordinated multidisciplinary care has been increasingly emphasized for oncology patients with a wide array of cancers including breast, pancreatic, and prostatic [1][2][3][4][5][6][7][8][9] . Weekly tumour boards and single-day multidisciplinary clinics both allow a variety of providers to review and contribute to the care plan of patients with cancer, but these two approaches have some important differences.…”

“…Although outcomes of multidisciplinary clinics have been described for several cancer types [1][2][3][4][5][6][7][8][9][12][13][14][15][16][17][18][19][20] , no study to date has documented the outcomes of a single-day liver multidisciplinary clinic. The multidisciplinary liver clinic (mdlc) at the Johns Hopkins Hospital (jhh) was established in 2009 so that patients with liver tumours could be evaluated by a range of specialists within the same visit day and site.…”

“…Multidisciplinary clinics can, however, be more resource-intense and might require providers to deviate from their normal clinic routine. Multidisciplinary cancer clinics have been adopted for patients with breast 1-3 , gynecologic [12][13][14] , pancreatic 4,5 , lung 13,15 , skin [16][17][18] , head-and-neck 19,20 , and prostate malignancies [6][7][8][9] . Multidisciplinary clinics have even been proposed for patients with specific types of metastases 21 .…”

“…In most hospitals, multidisciplinary care consists of separate clinic visits with various specialists in conjunction with a weekly tumour board discussion. One reason for the emphasis on this approach is the accumulating evidence that multidisciplinary care leads to more favourable patient outcomes [1][2][3][4][5][6][7][8][9] . In this regard, contemporary recommendations support the management of oncologic patients by a multidisciplinary team including surgical oncologists, medical oncologists,…”

Current therapeutic strategies for advanced pancreatic cancer: A review for clinicians

“…Large prospective randomised studies are mandatory to assess the efficacy of these techniques and define their role/position in future treatment algorithms for the management of LAPC. Their main interest is in the context of a multidisciplinary-team patient evaluation, that is the best option to help patients cope with this challenging cancer [104][105][106] .…”