567. MDT OPTIMIZATION FOR DIAGNOSTIC WORKUP OF ESOPHAGEAL CANCER

Abstract

Abstract Rapid and complete workup of esophageal cancer is vital for a timely and individual treatment strategy. The aim of this study is to uncover potential delay, inefficiencies and non-contributing investigations in the diagnostic process. This retrospective cohort study included all esophageal cancer patients referred to or diagnosed in the Amsterdam UMC or Karolinska Institutet between July 2020 and July 2021. Radiology, pathological assessment and MDT meeting reports were reviewed. To assess time interval from diagnosis to treatment, information on date of diagnosis, admittance to referral hospital, MDT and start treatment was collected. This study included 252 esophageal cancer patients, 187 were treated with curative intent. Curative patients had a median age of 68, were predominantly male (74.9%) with adenocarcinoma (71.4%). Patients had a median of 34 days (IQR:27-43) between diagnosis and start treatment and a median time to referral of 6 days (IQR:0-11). Main denominators for prolonged time between diagnosis and treatment was need for additional diagnostics (45.5%) and local protocol (Amsterdam UMC 39 days vs Karolinska 27 days). However, for 33 out of 77 patients (42.9%), no other than logistical reasons could be found. Differences in time between diagnosis and treatment in the centers can be explained by variations in workup protocol, MDT regulations and the need for additional diagnostics.