This article is more than 5 years old. Information may no longer be current.
Multidisciplinary care benefits patients with rectal cancer
Click Here to Manage Email Alerts
Patients with rectal cancer could benefit if medical institutions implement multidisciplinary team approaches to managing their disease, according to two studies published in the Journal of the American College of Surgeons.
The research was spurred by the development of the National Accreditation Program for Rectal Cancer (NAPRC) — a quality improvement program administered by the American College of Surgeons to improve care by promoting multidisciplinary collaboration.
“Cancer care, and rectal cancer care in particular, requires a team approach as there are multiple specialties that each deliver a specific treatment modality,” Matthew Kalady, MD, FACS, co-director of the Cleveland Clinic Comprehensive Cancer Program said in a press release.
Kalady and colleagues conducted a study to determine how a colorectal cancer multidisciplinary conference (CRC-MDC) impacted the management of patients with rectal cancer.
The researchers reviewed 371 rectal cancer cases presented at the Cleveland Clinic’s weekly CRC-MDC between July 2015 and June 2016. They included patient demographics, clinical information and a physician questionnaire in their review.
There was a documented change in plan because of a CRC-MDC discussion in 97 of the 371 cases surveyed (26%), according to the study. The discussion resulted in changes to therapy or therapy sequence (n = 76) and recommendation of additional evaluation (n = 36).
Kalady and colleagues noted that the results supported the CRC-MDC standard for the NAPRC.
In the second study, Justin T. Brady, MD, of the department of surgery at University Hospitals Cleveland Medical Center, and colleagues reviewed information from the 2011-2014 National Cancer Database about patients with non-metastatic rectal cancer who underwent proctectomy (n = 39,068) to determine the status of rectal cancer treatment prior to the implementation of the NAPRC.
The investigators analyzed data on how many patients achieved clinical staging completion, treatment starting fewer than 60 days from diagnosis, carcinoembryonic antigen (CEA) level drawn before treatment, tumor regression grading and margin assessment, which are all process measures suggested by the NAPRC. Additionally, the NAPRC has performance measures, including negative proximal, distal, and circumferential margins, and harvesting 12 or more lymph nodes during resection.
The study authors found that only 28.1% of patients completed all the included process measures and 56.3% of patients achieved all the performance measures suggested in the NAPRC. They wrote it will be important to re-evaluate the data after the implementation of the program.
“Not every patient is the same, nor fits into a perfect category, and we need to treat each person as an individual when weighing treatment options,” Kalady said in the press release. “It’s also very important that all of the physicians on the team are on the same page and deliver a consistent message to the patient about the plan.” – by Alex Young
Disclosures : The authors reported no relevant financial disclosures.
Read more about
Click Here to Manage Email Alerts