EVALUATING THE IMPACT OF A MULTIDISCIPLINARY SINGLE DAY CLINIC ON THE MANAGEMENT OF PANCREATIC CANCER

Abstract

Purpose: For cancer treatment, a multidisciplinary model has become popular over the past ten years. Johns Hopkins Hospital (JHH) offers a single day comprehensive evaluation of a patient incorporating education, diagnosis, treatment, and research of pancreatic cancer by clinicians and specialists. The purpose of the study was to evaluate the impact of this approach on the management of pancreatic cancer. Methods: The medical records of 144 consecutive patients self and physician-referred to JHH's Pancreatic Multidisciplinary Cancer Clinic (PMDCC) were prospectively collected over a 9-month period. If necessary, new laboratory studies and radiologic scans were obtained at JHH the morning of the clinic. Available radiologic data, pathologic data, and medical histories were then evaluated by a panel of diagnostic radiologist, pathologist, geneticist, and medical, radiation, and surgical oncologists. After a consensus was reached, patients were subsequently seen by each specialty. Diagnosis, radiologic, pathologic, and surgical data were retrospectively compared before and after the PMDCC to determine if specific interpretations altered patient management. Results: Overall, 24% of all patients had a change in the management of their cancer following the PMDCC review. 16 patients had a change in diagnosis due to radiologic and pathologic review (11%). 20 patients had a change in cancer status (14%). 50 patients had a change in the interpretation of available scans or biopsies (35%). 14 patients had change in the resectability statusof their tumor (16%). Overall, 6 patients had pathologic interpretation changes in terms of tumor grade, subtype, and margin status. Enrollment into the National Familial Pancreatic Tumor Registry increased from 52 out of 106 (49%) to 158 out of 220 patients (72%) when compared to the previous year. Conclusions: The single day pancreatic multidisciplinary cancer clinic provided efficient and integrated evaluation that led to changes in cancer care management in 24% of (35 out of 144) patients.