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Shen W, Xu C, Wang P, Chen J, Yu D, Zhu H. Giant Mandibular Ameloblastoma with Rare Hypercalcemia: A Case Report and Literature Review. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1956. [PMID: 38004005 PMCID: PMC10673442 DOI: 10.3390/medicina59111956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/18/2023] [Accepted: 11/01/2023] [Indexed: 11/26/2023]
Abstract
Ameloblastoma is the most common benign odontogenic tumor with local invasion and high recurrence, which generally occurs in the jaw bones. Hypercalcemia is a common paraneoplastic syndrome that is commonly observed in patients with malignancies but rarely encountered in patients with benign tumors. Thus far, not many cases of ameloblastoma with hypercalcemia have been reported, and the pathogenic mechanism has not been studied in depth. This paper presents a case report of a 26-year-old male diagnosed with giant ameloblastoma of the mandible, accompanied by rare hypercalcemia. Additionally, a review of the relevant literature is conducted. This patient initially underwent marsupialization, yet this treatment was not effective, which indicated that the selection of the appropriate operation is of prime importance for improving the prognosis of patients with ameloblastoma. The tumor not only failed to shrink but gradually increased in size, accompanied by multiple complications including hypercalcemia, renal dysfunction, anemia, and cachexia. Due to the contradiction between the necessity of tumor resection and the patient's poor systemic condition, we implemented a multi-disciplinary team (MDT) meeting to better evaluate this patient's condition and design an individualized treatment strategy. The patient subsequently received a variety of interventions to improve the general conditions until he could tolerate surgery, and finally underwent the successful resection of giant ameloblastoma and reconstruction with vascularized fibular flap. No tumor recurrence or distance metastasis was observed during 5 years of follow-up. Additionally, the absence of hypercalcemia recurrence was also noted.
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Affiliation(s)
- Wenyi Shen
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; (W.S.); (C.X.); (P.W.); (J.C.)
- Department of Stomatology, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Chenlu Xu
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; (W.S.); (C.X.); (P.W.); (J.C.)
- Department of Stomatology, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Pan Wang
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; (W.S.); (C.X.); (P.W.); (J.C.)
- Department of Stomatology, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Junpeng Chen
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; (W.S.); (C.X.); (P.W.); (J.C.)
- Department of Stomatology, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Dan Yu
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; (W.S.); (C.X.); (P.W.); (J.C.)
- Department of Stomatology, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Huiyong Zhu
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; (W.S.); (C.X.); (P.W.); (J.C.)
- Department of Stomatology, Zhejiang University School of Medicine, Hangzhou 310058, China
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Fusetti V, Angi M, Caraceni AT, Di Guardo L, Regalia E, Bosisio M, Lo Dico S, Pigni A, Brunelli C, Lusignani M. Palliative Care Nursing Case Management in Young Adults With Advanced Rare Cancer: Case Discussion of a Multidisciplinary Approach. Prof Case Manag 2023; 28:280-287. [PMID: 37787706 DOI: 10.1097/ncm.0000000000000668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
Purpose/Objectives:
This case aims to identify the elements of care continuity that are lacking in young adult patients with advanced rare cancer, suggesting ways to enhance continuity of care through nurse case manager/management (NCM) interventions and describing their impact on the emotional burden of patients and their families.
Primary Practice Setting(s):
Comprehensive cancer center.
Findings/Conclusions:
The dyadic care alliance with the NCM can alleviate disease burden, fostering trust in the team and adherence to care advice, thus reducing the patient's distress. The NCM can be an efficient option to advocate for patient needs on the multidisciplinary team, addressing practical issues and the unmet needs of patients and their caregivers, and facilitating referrals to other professionals. The study also shows that caring for young adults with advanced rare cancers should include mindful evaluation of their significant others.
Implications for Case Management Practice:
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Affiliation(s)
- Viviana Fusetti
- Viviana Fusetti, MSN, RN , is a case manager and nurse researcher at the Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori of Milan. She completed the MSN in research and management and is now attending the PhD in Nursing Science and Public Health. She is affiliated with Università degli Studi di Roma Tor Vergata, Rome, Italy, and National Cancer Institute, Milan, Italy
- Martina Angi, MD , is a medical doctor specialized in ocular oncology, is now hospital doctor in the Ocular Oncology Unit of the National Cancer Institute of Milan. She is expert in surgical treatment of uveal melanoma. She is affiliated with National Cancer Institute, Milan, Italy
- Augusto T. Caraceni, MD , is a head physician of the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan, and director of the School of Specialization in Palliative Care Medicine of the Università degli Studi di Milano. He is also the cochairman of the European Center for Palliative Care Research. He is affiliated with National Cancer Institute, Milan, Italy, and Università degli Studi di Milano, Milan, Italy
- Lorenza Di Guardo, MD , is a medical doctor specialized in medical oncology and is now hospital doctor in the Medical Oncology Unit of the National Cancer Institute of Milan. She is expert in medical diagnosis and treatment skin and uveal melanoma. She is affiliated with National Cancer Institute, Milan, Italy
- Enrico Regalia, MD , is a medical doctor specialized in surgery and medical oncology and is now hospital doctor in the HPD Surgery and Liver Transplantation Unit of the National Cancer Institute of Milan. He is expert in surgical treatment of liver cancer. He is affiliated with National Cancer Institute, Milan, Italy
- Marco Bosisio, PsyD , is a psychotherapist in the Clinical Psychology Unit of the National Cancer Institute of Milan. He serves as clinician, researcher, and member of the board of directors in the School of Psycho-oncology of the same institution. He is affiliated with National Cancer Institute, Milan, Italy
- Silvia Lo Dico, MD , is a medical doctor specialized in medical oncology. She is now hospital doctor in the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan. She is expert in medical diagnosis and treatment of cancer-related symptoms management. She is affiliated with National Cancer Institute, Milan, Italy
- Alessandra Pigni, MD , is a medical doctor specialized in medical oncology. She is senior researcher at the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan. Coinvestigator of several national and international institutional clinical trials, she performed didactic activity at university and on professional and institutional educational programs. She is affiliated with National Cancer Institute, Milan, Italy
- Cinzia Brunelli, PhD , is a statistician and senior researcher in the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan. She completed PhD in palliative care and currently she is associated editor of the supportive and palliative care section of Tumori Journal . She is affiliated with National Cancer Institute, Milan, Italy
- Maura Lusignani, MSN, RN, is a head of the bachelor degree in nursing and president of the MSc in Nursing of the Università degli Studi di Milano. She directs many master courses with a focus on nursing leadership. Recently, she became full professor in nursing sciences in the same university. She is affiliated with Università degli Studi di Milano, Milan, Italy, and Bachelor School of Nursing, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Martina Angi
- Viviana Fusetti, MSN, RN , is a case manager and nurse researcher at the Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori of Milan. She completed the MSN in research and management and is now attending the PhD in Nursing Science and Public Health. She is affiliated with Università degli Studi di Roma Tor Vergata, Rome, Italy, and National Cancer Institute, Milan, Italy
- Martina Angi, MD , is a medical doctor specialized in ocular oncology, is now hospital doctor in the Ocular Oncology Unit of the National Cancer Institute of Milan. She is expert in surgical treatment of uveal melanoma. She is affiliated with National Cancer Institute, Milan, Italy
- Augusto T. Caraceni, MD , is a head physician of the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan, and director of the School of Specialization in Palliative Care Medicine of the Università degli Studi di Milano. He is also the cochairman of the European Center for Palliative Care Research. He is affiliated with National Cancer Institute, Milan, Italy, and Università degli Studi di Milano, Milan, Italy
- Lorenza Di Guardo, MD , is a medical doctor specialized in medical oncology and is now hospital doctor in the Medical Oncology Unit of the National Cancer Institute of Milan. She is expert in medical diagnosis and treatment skin and uveal melanoma. She is affiliated with National Cancer Institute, Milan, Italy
- Enrico Regalia, MD , is a medical doctor specialized in surgery and medical oncology and is now hospital doctor in the HPD Surgery and Liver Transplantation Unit of the National Cancer Institute of Milan. He is expert in surgical treatment of liver cancer. He is affiliated with National Cancer Institute, Milan, Italy
- Marco Bosisio, PsyD , is a psychotherapist in the Clinical Psychology Unit of the National Cancer Institute of Milan. He serves as clinician, researcher, and member of the board of directors in the School of Psycho-oncology of the same institution. He is affiliated with National Cancer Institute, Milan, Italy
- Silvia Lo Dico, MD , is a medical doctor specialized in medical oncology. She is now hospital doctor in the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan. She is expert in medical diagnosis and treatment of cancer-related symptoms management. She is affiliated with National Cancer Institute, Milan, Italy
- Alessandra Pigni, MD , is a medical doctor specialized in medical oncology. She is senior researcher at the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan. Coinvestigator of several national and international institutional clinical trials, she performed didactic activity at university and on professional and institutional educational programs. She is affiliated with National Cancer Institute, Milan, Italy
- Cinzia Brunelli, PhD , is a statistician and senior researcher in the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan. She completed PhD in palliative care and currently she is associated editor of the supportive and palliative care section of Tumori Journal . She is affiliated with National Cancer Institute, Milan, Italy
- Maura Lusignani, MSN, RN, is a head of the bachelor degree in nursing and president of the MSc in Nursing of the Università degli Studi di Milano. She directs many master courses with a focus on nursing leadership. Recently, she became full professor in nursing sciences in the same university. She is affiliated with Università degli Studi di Milano, Milan, Italy, and Bachelor School of Nursing, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Augusto T Caraceni
- Viviana Fusetti, MSN, RN , is a case manager and nurse researcher at the Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori of Milan. She completed the MSN in research and management and is now attending the PhD in Nursing Science and Public Health. She is affiliated with Università degli Studi di Roma Tor Vergata, Rome, Italy, and National Cancer Institute, Milan, Italy
- Martina Angi, MD , is a medical doctor specialized in ocular oncology, is now hospital doctor in the Ocular Oncology Unit of the National Cancer Institute of Milan. She is expert in surgical treatment of uveal melanoma. She is affiliated with National Cancer Institute, Milan, Italy
- Augusto T. Caraceni, MD , is a head physician of the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan, and director of the School of Specialization in Palliative Care Medicine of the Università degli Studi di Milano. He is also the cochairman of the European Center for Palliative Care Research. He is affiliated with National Cancer Institute, Milan, Italy, and Università degli Studi di Milano, Milan, Italy
- Lorenza Di Guardo, MD , is a medical doctor specialized in medical oncology and is now hospital doctor in the Medical Oncology Unit of the National Cancer Institute of Milan. She is expert in medical diagnosis and treatment skin and uveal melanoma. She is affiliated with National Cancer Institute, Milan, Italy
- Enrico Regalia, MD , is a medical doctor specialized in surgery and medical oncology and is now hospital doctor in the HPD Surgery and Liver Transplantation Unit of the National Cancer Institute of Milan. He is expert in surgical treatment of liver cancer. He is affiliated with National Cancer Institute, Milan, Italy
- Marco Bosisio, PsyD , is a psychotherapist in the Clinical Psychology Unit of the National Cancer Institute of Milan. He serves as clinician, researcher, and member of the board of directors in the School of Psycho-oncology of the same institution. He is affiliated with National Cancer Institute, Milan, Italy
- Silvia Lo Dico, MD , is a medical doctor specialized in medical oncology. She is now hospital doctor in the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan. She is expert in medical diagnosis and treatment of cancer-related symptoms management. She is affiliated with National Cancer Institute, Milan, Italy
- Alessandra Pigni, MD , is a medical doctor specialized in medical oncology. She is senior researcher at the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan. Coinvestigator of several national and international institutional clinical trials, she performed didactic activity at university and on professional and institutional educational programs. She is affiliated with National Cancer Institute, Milan, Italy
- Cinzia Brunelli, PhD , is a statistician and senior researcher in the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan. She completed PhD in palliative care and currently she is associated editor of the supportive and palliative care section of Tumori Journal . She is affiliated with National Cancer Institute, Milan, Italy
- Maura Lusignani, MSN, RN, is a head of the bachelor degree in nursing and president of the MSc in Nursing of the Università degli Studi di Milano. She directs many master courses with a focus on nursing leadership. Recently, she became full professor in nursing sciences in the same university. She is affiliated with Università degli Studi di Milano, Milan, Italy, and Bachelor School of Nursing, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Lorenza Di Guardo
- Viviana Fusetti, MSN, RN , is a case manager and nurse researcher at the Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori of Milan. She completed the MSN in research and management and is now attending the PhD in Nursing Science and Public Health. She is affiliated with Università degli Studi di Roma Tor Vergata, Rome, Italy, and National Cancer Institute, Milan, Italy
- Martina Angi, MD , is a medical doctor specialized in ocular oncology, is now hospital doctor in the Ocular Oncology Unit of the National Cancer Institute of Milan. She is expert in surgical treatment of uveal melanoma. She is affiliated with National Cancer Institute, Milan, Italy
- Augusto T. Caraceni, MD , is a head physician of the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan, and director of the School of Specialization in Palliative Care Medicine of the Università degli Studi di Milano. He is also the cochairman of the European Center for Palliative Care Research. He is affiliated with National Cancer Institute, Milan, Italy, and Università degli Studi di Milano, Milan, Italy
- Lorenza Di Guardo, MD , is a medical doctor specialized in medical oncology and is now hospital doctor in the Medical Oncology Unit of the National Cancer Institute of Milan. She is expert in medical diagnosis and treatment skin and uveal melanoma. She is affiliated with National Cancer Institute, Milan, Italy
- Enrico Regalia, MD , is a medical doctor specialized in surgery and medical oncology and is now hospital doctor in the HPD Surgery and Liver Transplantation Unit of the National Cancer Institute of Milan. He is expert in surgical treatment of liver cancer. He is affiliated with National Cancer Institute, Milan, Italy
- Marco Bosisio, PsyD , is a psychotherapist in the Clinical Psychology Unit of the National Cancer Institute of Milan. He serves as clinician, researcher, and member of the board of directors in the School of Psycho-oncology of the same institution. He is affiliated with National Cancer Institute, Milan, Italy
- Silvia Lo Dico, MD , is a medical doctor specialized in medical oncology. She is now hospital doctor in the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan. She is expert in medical diagnosis and treatment of cancer-related symptoms management. She is affiliated with National Cancer Institute, Milan, Italy
- Alessandra Pigni, MD , is a medical doctor specialized in medical oncology. She is senior researcher at the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan. Coinvestigator of several national and international institutional clinical trials, she performed didactic activity at university and on professional and institutional educational programs. She is affiliated with National Cancer Institute, Milan, Italy
- Cinzia Brunelli, PhD , is a statistician and senior researcher in the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan. She completed PhD in palliative care and currently she is associated editor of the supportive and palliative care section of Tumori Journal . She is affiliated with National Cancer Institute, Milan, Italy
- Maura Lusignani, MSN, RN, is a head of the bachelor degree in nursing and president of the MSc in Nursing of the Università degli Studi di Milano. She directs many master courses with a focus on nursing leadership. Recently, she became full professor in nursing sciences in the same university. She is affiliated with Università degli Studi di Milano, Milan, Italy, and Bachelor School of Nursing, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Enrico Regalia
- Viviana Fusetti, MSN, RN , is a case manager and nurse researcher at the Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori of Milan. She completed the MSN in research and management and is now attending the PhD in Nursing Science and Public Health. She is affiliated with Università degli Studi di Roma Tor Vergata, Rome, Italy, and National Cancer Institute, Milan, Italy
- Martina Angi, MD , is a medical doctor specialized in ocular oncology, is now hospital doctor in the Ocular Oncology Unit of the National Cancer Institute of Milan. She is expert in surgical treatment of uveal melanoma. She is affiliated with National Cancer Institute, Milan, Italy
- Augusto T. Caraceni, MD , is a head physician of the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan, and director of the School of Specialization in Palliative Care Medicine of the Università degli Studi di Milano. He is also the cochairman of the European Center for Palliative Care Research. He is affiliated with National Cancer Institute, Milan, Italy, and Università degli Studi di Milano, Milan, Italy
- Lorenza Di Guardo, MD , is a medical doctor specialized in medical oncology and is now hospital doctor in the Medical Oncology Unit of the National Cancer Institute of Milan. She is expert in medical diagnosis and treatment skin and uveal melanoma. She is affiliated with National Cancer Institute, Milan, Italy
- Enrico Regalia, MD , is a medical doctor specialized in surgery and medical oncology and is now hospital doctor in the HPD Surgery and Liver Transplantation Unit of the National Cancer Institute of Milan. He is expert in surgical treatment of liver cancer. He is affiliated with National Cancer Institute, Milan, Italy
- Marco Bosisio, PsyD , is a psychotherapist in the Clinical Psychology Unit of the National Cancer Institute of Milan. He serves as clinician, researcher, and member of the board of directors in the School of Psycho-oncology of the same institution. He is affiliated with National Cancer Institute, Milan, Italy
- Silvia Lo Dico, MD , is a medical doctor specialized in medical oncology. She is now hospital doctor in the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan. She is expert in medical diagnosis and treatment of cancer-related symptoms management. She is affiliated with National Cancer Institute, Milan, Italy
- Alessandra Pigni, MD , is a medical doctor specialized in medical oncology. She is senior researcher at the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan. Coinvestigator of several national and international institutional clinical trials, she performed didactic activity at university and on professional and institutional educational programs. She is affiliated with National Cancer Institute, Milan, Italy
- Cinzia Brunelli, PhD , is a statistician and senior researcher in the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan. She completed PhD in palliative care and currently she is associated editor of the supportive and palliative care section of Tumori Journal . She is affiliated with National Cancer Institute, Milan, Italy
- Maura Lusignani, MSN, RN, is a head of the bachelor degree in nursing and president of the MSc in Nursing of the Università degli Studi di Milano. She directs many master courses with a focus on nursing leadership. Recently, she became full professor in nursing sciences in the same university. She is affiliated with Università degli Studi di Milano, Milan, Italy, and Bachelor School of Nursing, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Marco Bosisio
- Viviana Fusetti, MSN, RN , is a case manager and nurse researcher at the Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori of Milan. She completed the MSN in research and management and is now attending the PhD in Nursing Science and Public Health. She is affiliated with Università degli Studi di Roma Tor Vergata, Rome, Italy, and National Cancer Institute, Milan, Italy
- Martina Angi, MD , is a medical doctor specialized in ocular oncology, is now hospital doctor in the Ocular Oncology Unit of the National Cancer Institute of Milan. She is expert in surgical treatment of uveal melanoma. She is affiliated with National Cancer Institute, Milan, Italy
- Augusto T. Caraceni, MD , is a head physician of the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan, and director of the School of Specialization in Palliative Care Medicine of the Università degli Studi di Milano. He is also the cochairman of the European Center for Palliative Care Research. He is affiliated with National Cancer Institute, Milan, Italy, and Università degli Studi di Milano, Milan, Italy
- Lorenza Di Guardo, MD , is a medical doctor specialized in medical oncology and is now hospital doctor in the Medical Oncology Unit of the National Cancer Institute of Milan. She is expert in medical diagnosis and treatment skin and uveal melanoma. She is affiliated with National Cancer Institute, Milan, Italy
- Enrico Regalia, MD , is a medical doctor specialized in surgery and medical oncology and is now hospital doctor in the HPD Surgery and Liver Transplantation Unit of the National Cancer Institute of Milan. He is expert in surgical treatment of liver cancer. He is affiliated with National Cancer Institute, Milan, Italy
- Marco Bosisio, PsyD , is a psychotherapist in the Clinical Psychology Unit of the National Cancer Institute of Milan. He serves as clinician, researcher, and member of the board of directors in the School of Psycho-oncology of the same institution. He is affiliated with National Cancer Institute, Milan, Italy
- Silvia Lo Dico, MD , is a medical doctor specialized in medical oncology. She is now hospital doctor in the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan. She is expert in medical diagnosis and treatment of cancer-related symptoms management. She is affiliated with National Cancer Institute, Milan, Italy
- Alessandra Pigni, MD , is a medical doctor specialized in medical oncology. She is senior researcher at the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan. Coinvestigator of several national and international institutional clinical trials, she performed didactic activity at university and on professional and institutional educational programs. She is affiliated with National Cancer Institute, Milan, Italy
- Cinzia Brunelli, PhD , is a statistician and senior researcher in the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan. She completed PhD in palliative care and currently she is associated editor of the supportive and palliative care section of Tumori Journal . She is affiliated with National Cancer Institute, Milan, Italy
- Maura Lusignani, MSN, RN, is a head of the bachelor degree in nursing and president of the MSc in Nursing of the Università degli Studi di Milano. She directs many master courses with a focus on nursing leadership. Recently, she became full professor in nursing sciences in the same university. She is affiliated with Università degli Studi di Milano, Milan, Italy, and Bachelor School of Nursing, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Silvia Lo Dico
- Viviana Fusetti, MSN, RN , is a case manager and nurse researcher at the Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori of Milan. She completed the MSN in research and management and is now attending the PhD in Nursing Science and Public Health. She is affiliated with Università degli Studi di Roma Tor Vergata, Rome, Italy, and National Cancer Institute, Milan, Italy
- Martina Angi, MD , is a medical doctor specialized in ocular oncology, is now hospital doctor in the Ocular Oncology Unit of the National Cancer Institute of Milan. She is expert in surgical treatment of uveal melanoma. She is affiliated with National Cancer Institute, Milan, Italy
- Augusto T. Caraceni, MD , is a head physician of the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan, and director of the School of Specialization in Palliative Care Medicine of the Università degli Studi di Milano. He is also the cochairman of the European Center for Palliative Care Research. He is affiliated with National Cancer Institute, Milan, Italy, and Università degli Studi di Milano, Milan, Italy
- Lorenza Di Guardo, MD , is a medical doctor specialized in medical oncology and is now hospital doctor in the Medical Oncology Unit of the National Cancer Institute of Milan. She is expert in medical diagnosis and treatment skin and uveal melanoma. She is affiliated with National Cancer Institute, Milan, Italy
- Enrico Regalia, MD , is a medical doctor specialized in surgery and medical oncology and is now hospital doctor in the HPD Surgery and Liver Transplantation Unit of the National Cancer Institute of Milan. He is expert in surgical treatment of liver cancer. He is affiliated with National Cancer Institute, Milan, Italy
- Marco Bosisio, PsyD , is a psychotherapist in the Clinical Psychology Unit of the National Cancer Institute of Milan. He serves as clinician, researcher, and member of the board of directors in the School of Psycho-oncology of the same institution. He is affiliated with National Cancer Institute, Milan, Italy
- Silvia Lo Dico, MD , is a medical doctor specialized in medical oncology. She is now hospital doctor in the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan. She is expert in medical diagnosis and treatment of cancer-related symptoms management. She is affiliated with National Cancer Institute, Milan, Italy
- Alessandra Pigni, MD , is a medical doctor specialized in medical oncology. She is senior researcher at the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan. Coinvestigator of several national and international institutional clinical trials, she performed didactic activity at university and on professional and institutional educational programs. She is affiliated with National Cancer Institute, Milan, Italy
- Cinzia Brunelli, PhD , is a statistician and senior researcher in the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan. She completed PhD in palliative care and currently she is associated editor of the supportive and palliative care section of Tumori Journal . She is affiliated with National Cancer Institute, Milan, Italy
- Maura Lusignani, MSN, RN, is a head of the bachelor degree in nursing and president of the MSc in Nursing of the Università degli Studi di Milano. She directs many master courses with a focus on nursing leadership. Recently, she became full professor in nursing sciences in the same university. She is affiliated with Università degli Studi di Milano, Milan, Italy, and Bachelor School of Nursing, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Alessandra Pigni
- Viviana Fusetti, MSN, RN , is a case manager and nurse researcher at the Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori of Milan. She completed the MSN in research and management and is now attending the PhD in Nursing Science and Public Health. She is affiliated with Università degli Studi di Roma Tor Vergata, Rome, Italy, and National Cancer Institute, Milan, Italy
- Martina Angi, MD , is a medical doctor specialized in ocular oncology, is now hospital doctor in the Ocular Oncology Unit of the National Cancer Institute of Milan. She is expert in surgical treatment of uveal melanoma. She is affiliated with National Cancer Institute, Milan, Italy
- Augusto T. Caraceni, MD , is a head physician of the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan, and director of the School of Specialization in Palliative Care Medicine of the Università degli Studi di Milano. He is also the cochairman of the European Center for Palliative Care Research. He is affiliated with National Cancer Institute, Milan, Italy, and Università degli Studi di Milano, Milan, Italy
- Lorenza Di Guardo, MD , is a medical doctor specialized in medical oncology and is now hospital doctor in the Medical Oncology Unit of the National Cancer Institute of Milan. She is expert in medical diagnosis and treatment skin and uveal melanoma. She is affiliated with National Cancer Institute, Milan, Italy
- Enrico Regalia, MD , is a medical doctor specialized in surgery and medical oncology and is now hospital doctor in the HPD Surgery and Liver Transplantation Unit of the National Cancer Institute of Milan. He is expert in surgical treatment of liver cancer. He is affiliated with National Cancer Institute, Milan, Italy
- Marco Bosisio, PsyD , is a psychotherapist in the Clinical Psychology Unit of the National Cancer Institute of Milan. He serves as clinician, researcher, and member of the board of directors in the School of Psycho-oncology of the same institution. He is affiliated with National Cancer Institute, Milan, Italy
- Silvia Lo Dico, MD , is a medical doctor specialized in medical oncology. She is now hospital doctor in the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan. She is expert in medical diagnosis and treatment of cancer-related symptoms management. She is affiliated with National Cancer Institute, Milan, Italy
- Alessandra Pigni, MD , is a medical doctor specialized in medical oncology. She is senior researcher at the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan. Coinvestigator of several national and international institutional clinical trials, she performed didactic activity at university and on professional and institutional educational programs. She is affiliated with National Cancer Institute, Milan, Italy
- Cinzia Brunelli, PhD , is a statistician and senior researcher in the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan. She completed PhD in palliative care and currently she is associated editor of the supportive and palliative care section of Tumori Journal . She is affiliated with National Cancer Institute, Milan, Italy
- Maura Lusignani, MSN, RN, is a head of the bachelor degree in nursing and president of the MSc in Nursing of the Università degli Studi di Milano. She directs many master courses with a focus on nursing leadership. Recently, she became full professor in nursing sciences in the same university. She is affiliated with Università degli Studi di Milano, Milan, Italy, and Bachelor School of Nursing, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Cinzia Brunelli
- Viviana Fusetti, MSN, RN , is a case manager and nurse researcher at the Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori of Milan. She completed the MSN in research and management and is now attending the PhD in Nursing Science and Public Health. She is affiliated with Università degli Studi di Roma Tor Vergata, Rome, Italy, and National Cancer Institute, Milan, Italy
- Martina Angi, MD , is a medical doctor specialized in ocular oncology, is now hospital doctor in the Ocular Oncology Unit of the National Cancer Institute of Milan. She is expert in surgical treatment of uveal melanoma. She is affiliated with National Cancer Institute, Milan, Italy
- Augusto T. Caraceni, MD , is a head physician of the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan, and director of the School of Specialization in Palliative Care Medicine of the Università degli Studi di Milano. He is also the cochairman of the European Center for Palliative Care Research. He is affiliated with National Cancer Institute, Milan, Italy, and Università degli Studi di Milano, Milan, Italy
- Lorenza Di Guardo, MD , is a medical doctor specialized in medical oncology and is now hospital doctor in the Medical Oncology Unit of the National Cancer Institute of Milan. She is expert in medical diagnosis and treatment skin and uveal melanoma. She is affiliated with National Cancer Institute, Milan, Italy
- Enrico Regalia, MD , is a medical doctor specialized in surgery and medical oncology and is now hospital doctor in the HPD Surgery and Liver Transplantation Unit of the National Cancer Institute of Milan. He is expert in surgical treatment of liver cancer. He is affiliated with National Cancer Institute, Milan, Italy
- Marco Bosisio, PsyD , is a psychotherapist in the Clinical Psychology Unit of the National Cancer Institute of Milan. He serves as clinician, researcher, and member of the board of directors in the School of Psycho-oncology of the same institution. He is affiliated with National Cancer Institute, Milan, Italy
- Silvia Lo Dico, MD , is a medical doctor specialized in medical oncology. She is now hospital doctor in the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan. She is expert in medical diagnosis and treatment of cancer-related symptoms management. She is affiliated with National Cancer Institute, Milan, Italy
- Alessandra Pigni, MD , is a medical doctor specialized in medical oncology. She is senior researcher at the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan. Coinvestigator of several national and international institutional clinical trials, she performed didactic activity at university and on professional and institutional educational programs. She is affiliated with National Cancer Institute, Milan, Italy
- Cinzia Brunelli, PhD , is a statistician and senior researcher in the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan. She completed PhD in palliative care and currently she is associated editor of the supportive and palliative care section of Tumori Journal . She is affiliated with National Cancer Institute, Milan, Italy
- Maura Lusignani, MSN, RN, is a head of the bachelor degree in nursing and president of the MSc in Nursing of the Università degli Studi di Milano. She directs many master courses with a focus on nursing leadership. Recently, she became full professor in nursing sciences in the same university. She is affiliated with Università degli Studi di Milano, Milan, Italy, and Bachelor School of Nursing, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Maura Lusignani
- Viviana Fusetti, MSN, RN , is a case manager and nurse researcher at the Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori of Milan. She completed the MSN in research and management and is now attending the PhD in Nursing Science and Public Health. She is affiliated with Università degli Studi di Roma Tor Vergata, Rome, Italy, and National Cancer Institute, Milan, Italy
- Martina Angi, MD , is a medical doctor specialized in ocular oncology, is now hospital doctor in the Ocular Oncology Unit of the National Cancer Institute of Milan. She is expert in surgical treatment of uveal melanoma. She is affiliated with National Cancer Institute, Milan, Italy
- Augusto T. Caraceni, MD , is a head physician of the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan, and director of the School of Specialization in Palliative Care Medicine of the Università degli Studi di Milano. He is also the cochairman of the European Center for Palliative Care Research. He is affiliated with National Cancer Institute, Milan, Italy, and Università degli Studi di Milano, Milan, Italy
- Lorenza Di Guardo, MD , is a medical doctor specialized in medical oncology and is now hospital doctor in the Medical Oncology Unit of the National Cancer Institute of Milan. She is expert in medical diagnosis and treatment skin and uveal melanoma. She is affiliated with National Cancer Institute, Milan, Italy
- Enrico Regalia, MD , is a medical doctor specialized in surgery and medical oncology and is now hospital doctor in the HPD Surgery and Liver Transplantation Unit of the National Cancer Institute of Milan. He is expert in surgical treatment of liver cancer. He is affiliated with National Cancer Institute, Milan, Italy
- Marco Bosisio, PsyD , is a psychotherapist in the Clinical Psychology Unit of the National Cancer Institute of Milan. He serves as clinician, researcher, and member of the board of directors in the School of Psycho-oncology of the same institution. He is affiliated with National Cancer Institute, Milan, Italy
- Silvia Lo Dico, MD , is a medical doctor specialized in medical oncology. She is now hospital doctor in the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan. She is expert in medical diagnosis and treatment of cancer-related symptoms management. She is affiliated with National Cancer Institute, Milan, Italy
- Alessandra Pigni, MD , is a medical doctor specialized in medical oncology. She is senior researcher at the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan. Coinvestigator of several national and international institutional clinical trials, she performed didactic activity at university and on professional and institutional educational programs. She is affiliated with National Cancer Institute, Milan, Italy
- Cinzia Brunelli, PhD , is a statistician and senior researcher in the Palliative Care, Pain Therapy and Rehabilitation Unit of the National Cancer Institute of Milan. She completed PhD in palliative care and currently she is associated editor of the supportive and palliative care section of Tumori Journal . She is affiliated with National Cancer Institute, Milan, Italy
- Maura Lusignani, MSN, RN, is a head of the bachelor degree in nursing and president of the MSc in Nursing of the Università degli Studi di Milano. She directs many master courses with a focus on nursing leadership. Recently, she became full professor in nursing sciences in the same university. She is affiliated with Università degli Studi di Milano, Milan, Italy, and Bachelor School of Nursing, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
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3
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Anokwute MC, Preda V, Di Ieva A. Determining Contemporary Barriers to Effective Multidisciplinary Team Meetings in Neurological Surgery: A Review of the Literature. World Neurosurg 2023; 172:73-80. [PMID: 36754351 DOI: 10.1016/j.wneu.2023.01.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 01/19/2023] [Indexed: 02/10/2023]
Abstract
OBJECTIVE The integration of multidisciplinary team meetings (MDTMs) for neurosurgical care has been accepted worldwide. Our objective was to review the literature for the limiting factors to MDTMs that may introduce bias to patient care. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analysis was used to perform a literature review of MDTMs for neuro-oncology, pituitary oncology, cerebrovascular surgery, and spine surgery and spine oncology. Limiting factors to productive MDTMs and factors that introduce bias were identified, as well as determining whether MDTMs led to improved patient outcomes. RESULTS We identified 1264 manuscripts from a PubMed and Ovid Medline search, of which 27 of 500 neuro-oncology, 4 of 279 pituitary, and 11 of 260 spine surgery articles met our inclusion criteria. Of 224 cerebrovascular manuscripts, none met the criteria. Factors for productive MDTMs included quaternary/tertiary referral centers, nonhierarchical environment, regularly scheduled meetings, concise inclusion of nonmedical factors at the same level of importance as patient clinical information, inclusion of nonclinical participants, and use of clinical guidelines and institutional protocols to provide recommendations. Our review did not identify literature that described the use of artificial intelligence to reduce bias and guide clinical care. CONCLUSIONS The continued implementation of MDTMs in neurosurgery should be recommended but cautioned by limiting bias.
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Affiliation(s)
- Miracle C Anokwute
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia; Department of Neurosurgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Veronica Preda
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Antonio Di Ieva
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia; Computational NeuroSurgery (CNS) Lab, Macquarie University, Sydney, New South Wales, Australia.
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Blum TG, Morgan RL, Durieux V, Chorostowska-Wynimko J, Baldwin DR, Boyd J, Faivre-Finn C, Galateau-Salle F, Gamarra F, Grigoriu B, Hardavella G, Hauptmann M, Jakobsen E, Jovanovic D, Knaut P, Massard G, McPhelim J, Meert AP, Milroy R, Muhr R, Mutti L, Paesmans M, Powell P, Putora PM, Rawlinson J, Rich AL, Rigau D, de Ruysscher D, Sculier JP, Schepereel A, Subotic D, Van Schil P, Tonia T, Williams C, Berghmans T. European Respiratory Society guideline on various aspects of quality in lung cancer care. Eur Respir J 2023; 61:13993003.03201-2021. [PMID: 36396145 DOI: 10.1183/13993003.03201-2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 09/23/2022] [Indexed: 11/18/2022]
Abstract
This European Respiratory Society guideline is dedicated to the provision of good quality recommendations in lung cancer care. All the clinical recommendations contained were based on a comprehensive systematic review and evidence syntheses based on eight PICO (Patients, Intervention, Comparison, Outcomes) questions. The evidence was appraised in compliance with the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Evidence profiles and the GRADE Evidence to Decision frameworks were used to summarise results and to make the decision-making process transparent. A multidisciplinary Task Force panel of lung cancer experts formulated and consented the clinical recommendations following thorough discussions of the systematic review results. In particular, we have made recommendations relating to the following quality improvement measures deemed applicable to routine lung cancer care: 1) avoidance of delay in the diagnostic and therapeutic period, 2) integration of multidisciplinary teams and multidisciplinary consultations, 3) implementation of and adherence to lung cancer guidelines, 4) benefit of higher institutional/individual volume and advanced specialisation in lung cancer surgery and other procedures, 5) need for pathological confirmation of lesions in patients with pulmonary lesions and suspected lung cancer, and histological subtyping and molecular characterisation for actionable targets or response to treatment of confirmed lung cancers, 6) added value of early integration of palliative care teams or specialists, 7) advantage of integrating specific quality improvement measures, and 8) benefit of using patient decision tools. These recommendations should be reconsidered and updated, as appropriate, as new evidence becomes available.
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Affiliation(s)
- Torsten Gerriet Blum
- Department of Pneumology, Lungenklinik Heckeshorn, HELIOS Klinikum Emil von Behring, Berlin, Germany
| | - Rebecca L Morgan
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Valérie Durieux
- Bibliothèque des Sciences de la Santé, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Joanna Chorostowska-Wynimko
- Department of Genetics and Clinical Immunology, National Institute of Tuberculosis and Lung Diseases, Warsaw, Poland
| | - David R Baldwin
- Department of Respiratory Medicine, Nottingham University Hospitals, Nottingham, UK
| | | | - Corinne Faivre-Finn
- Division of Cancer Sciences, University of Manchester and The Christie NHS Foundation Trust, Manchester, UK
| | | | | | - Bogdan Grigoriu
- Intensive Care and Oncological Emergencies and Thoracic Oncology, Institut Jules Bordet, Centre des Tumeurs de l'Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Georgia Hardavella
- Department of Respiratory Medicine, King's College Hospital London, London, UK
- Department of Respiratory Medicine and Allergy, King's College London, London, UK
| | - Michael Hauptmann
- Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg, Neuruppin, Germany
| | - Erik Jakobsen
- Department of Thoracic Surgery, Odense University Hospital, Odense, Denmark
| | | | - Paul Knaut
- Department of Pneumology, Lungenklinik Heckeshorn, HELIOS Klinikum Emil von Behring, Berlin, Germany
| | - Gilbert Massard
- Faculty of Science, Technology and Medicine, University of Luxembourg and Department of Thoracic Surgery, Hôpitaux Robert Schuman, Luxembourg, Luxembourg
| | - John McPhelim
- Lung Cancer Nurse Specialist, Hairmyres Hospital, NHS Lanarkshire, East Kilbride, UK
| | - Anne-Pascale Meert
- Intensive Care and Oncological Emergencies and Thoracic Oncology, Institut Jules Bordet, Centre des Tumeurs de l'Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Robert Milroy
- Scottish Lung Cancer Forum, Glasgow Royal Infirmary, Glasgow, UK
| | - Riccardo Muhr
- Department of Pneumology, Lungenklinik Heckeshorn, HELIOS Klinikum Emil von Behring, Berlin, Germany
| | - Luciano Mutti
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
- SHRO/Temple University, Philadelphia, PA, USA
| | - Marianne Paesmans
- Data Centre, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | | | - Paul Martin Putora
- Departments of Radiation Oncology, Kantonsspital St Gallen, St Gallen and University of Bern, Bern, Switzerland
| | | | - Anna L Rich
- Department of Respiratory Medicine, Nottingham University Hospitals, Nottingham, UK
| | - David Rigau
- Iberoamerican Cochrane Center, Barcelona, Spain
| | - Dirk de Ruysscher
- Maastricht University Medical Center, Department of Radiation Oncology (Maastro Clinic), GROW School for Oncology and Developmental Biology, Maastricht, The Netherlands
- Erasmus Medical Center, Department of Radiation Oncology, Rotterdam, The Netherlands
| | - Jean-Paul Sculier
- Intensive Care and Oncological Emergencies and Thoracic Oncology, Institut Jules Bordet, Centre des Tumeurs de l'Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Arnaud Schepereel
- Pulmonary and Thoracic Oncology, Université de Lille, Inserm, CHU Lille, Lille, France
| | - Dragan Subotic
- Clinic for Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Paul Van Schil
- Department of Thoracic and Vascular Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Thomy Tonia
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | | | - Thierry Berghmans
- Thoracic Oncology, Institut Jules Bordet, Centre des Tumeurs de l'Université Libre de Bruxelles (ULB), Brussels, Belgium
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Avancini A, Belluomini L, Borsati A, Riva ST, Trestini I, Tregnago D, Dodi A, Lanza M, Pompili C, Mazzarotto R, Micheletto C, Motton M, Scarpa A, Schena F, Milella M, Pilotto S. Integrating supportive care into the multidisciplinary management of lung cancer: we can't wait any longer. Expert Rev Anticancer Ther 2022; 22:725-735. [PMID: 35608060 DOI: 10.1080/14737140.2022.2082410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Due to important achievements in terms of diagnostic and therapeutic tools and the complexity of the disease itself, lung cancer management needs a multidisciplinary approach. To date, the classical multidisciplinary team involves different healthcare providers mainly dedicated to lung cancer diagnosis and treatments. Nevertheless, the underlying disease and related treatments significantly impact on patient function and psychological well-being. In this sense, supportive care may offer the best approach to relieve and manage patient symptoms and treatment-related adverse events. AREAS COVERED Evidence report that exercise, nutrition, smoking cessation and psychological well-being bring many benefits in patients with lung cancer, from both a physical and socio-psychological points of view, and potentially improving their survival. Nevertheless, supportive care is rarely offered to patients, and even less frequently these needs are discussed within the multidisciplinary meeting. EXPERT OPINION Integrating supportive care as part of the standard multidisciplinary approach for lung cancer involves a series of challenges, the first one represented by the daily necessity of specialists, such as kinesiologists, dietitians, psycho-oncologists, able to deliver a personalized approach. In the era of precision medicine this is an essential step forward to guarantee comprehensive and patient-centered care for all patients with lung cancer.
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Affiliation(s)
- Alice Avancini
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.,Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Lorenzo Belluomini
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - Anita Borsati
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Silvia Teresa Riva
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - Ilaria Trestini
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - Daniela Tregnago
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - Alessandra Dodi
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - Massimo Lanza
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Cecilia Pompili
- Thoracic Surgery Department, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - Renzo Mazzarotto
- Section of Radiotherapy, Department of Surgery and Oncology, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - Claudio Micheletto
- Pulmonary Unit, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - Massimiliano Motton
- Radiology Department, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - Aldo Scarpa
- Section of Pathology, Department of Diagnostic and Public Health, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - Federico Schena
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Michele Milella
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - Sara Pilotto
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
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Jazieh A, Sağlam EK, Önal H, Abdelkader Y, Gaafar R, Dawoud E, Nassar M, Alshorbagy D, El Ashry H, Alsayed M. Real-world Treatment Patterns and Outcomes in Stage III Non-small Cell Lung Cancer: Middle East and Africa – KINDLE Study. Clin Lung Cancer 2022; 23:364-373. [DOI: 10.1016/j.cllc.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 02/01/2022] [Accepted: 02/03/2022] [Indexed: 11/03/2022]
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Lin T, Pham J, Paul E, Conron M, Wright G, Ball D, Mitchell P, Atkin N, Brand M, Zalcberg J, Stirling RG. Impacts of lung cancer multidisciplinary meeting presentation: Drivers and outcomes from a population registry retrospective cohort study. Lung Cancer 2021; 163:69-76. [PMID: 34923204 DOI: 10.1016/j.lungcan.2021.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 11/29/2021] [Accepted: 12/07/2021] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Multidisciplinary Meetings (MDM) are recommended in routine lung cancer care, however its broader impacts demand further evaluation. We assessed the drivers and impacts of MDM presentation in the Victorian Lung Cancer Registry (VLCR). METHODS We examined the effect of MDM presentation on receipt of treatment and survival in VLCR patients diagnosed between 2011 and 2020. We compared patient characteristics, drivers of MDM discussion and survival between the two groups. RESULTS Of 9,628 patients, 5,900 (61.3%) were discussed at MDM, 3,728 (38.7%) were not. In the non-MDM group, a lower proportion received surgery (22.1% vs. 31.2%), radiotherapy (34.2% vs. 44.4%) and chemotherapy (44.7% vs. 49.0%). Patients were less likely to be discussed if ≥80 years (OR 0.73, p < 0.001), of ECOG performance status (PS) 4 (OR 0.23, p < 0.001), clinical stage IV (OR 0.34, p < 0.001) or referred from regional (OR 0.52, p < 0.001) or private hospital (OR 0.18, p < 0.001). MDM-presented patients had better median survival (1.70 vs 0.75 years, p < 0.001) and lower adjusted mortality risk (HR 0.75; 0.71-0.80, p < 0.001), a protective effect consistent across all hospital types. Undocumented PS, histopathology and clinical stage were associated with lower likelihood of MDM discussion and worse mortality. CONCLUSIONS In the VLCR, being male, ≥80 years, of poorer PS, advanced clinical stage and poor clinical characterisation significantly disadvantaged patients in relation to MDM discussion. MDM-discussed patients were more likely to undergo treatment and had a 25% lower risk of mortality. This study supports the use of MDMs in lung cancer and identifies areas of inequity to be addressed.
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Affiliation(s)
- Tiffany Lin
- Department of Respiratory Medicine, Alfred Hospital, Melbourne, Australia
| | - Jonathan Pham
- Department of Respiratory Medicine, Alfred Hospital, Melbourne, Australia
| | - Eldho Paul
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Matthew Conron
- Department of Respiratory Medicine, St Vincent's Hospital, Melbourne, Australia
| | - Gavin Wright
- Victorian Comprehensive Cancer Centre, Melbourne, Australia
| | - David Ball
- Division of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Paul Mitchell
- Olivia Newton-John Cancer and Wellness Centre, Melbourne, Australia
| | - Nicola Atkin
- Parkville Integrated Palliative Care Service, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Margaret Brand
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - John Zalcberg
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Robert G Stirling
- Department of Respiratory Medicine, Alfred Hospital, Melbourne, Australia; Department of Medicine, Monash University, Melbourne, Australia.
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Guirado M, Sanchez-Hernandez A, Pijuan L, Teixido C, Gómez-Caamaño A, Cilleruelo-Ramos Á. Quality indicators and excellence requirements for a multidisciplinary lung cancer tumor board by the Spanish Lung Cancer Group. Clin Transl Oncol 2021; 24:446-459. [PMID: 34665437 PMCID: PMC8525055 DOI: 10.1007/s12094-021-02712-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 09/18/2021] [Indexed: 12/24/2022]
Abstract
Multidisciplinary care is needed to decide the best therapeutic approach and to provide optimal care to patients with lung cancer (LC). Multidisciplinary teams (MDTs) are optimal strategies for the management of patients with LC and have been associated with better outcomes, such as an increase in quality of life and survival. The Spanish Lung Cancer Group has promoted this review about the current situation of the existing national LC-MDTs, which also offers a set of excellence requirements and quality indicators to achieve the best care in any patient with LC. Time and sufficient resources; leadership; administrative and institutional support; and recording of activity are key factors for the success of LC-MDTs. A set of excellence requirements in terms of staff, resources and organization of the LC-MDT have been proposed. At last, a list of quality indicators has been agreed to achieve and measure the performance of current LC-MDTs.
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Affiliation(s)
- M Guirado
- Medical Oncology Department, Hospital General Universitario de Elche, 03203, Elche, Spain
| | - A Sanchez-Hernandez
- Medical Oncology Department, Consorcio Hospitalario Provincial de Castellón, 12002, Castellón de la Plana, Spain
| | - L Pijuan
- Pathology Department, Bellvitge University Hospital, 08907, L'Hospitalet de Llobregat, Spain
| | - C Teixido
- Thoracic Oncology Unit, Department of Pathology, IDIBAPS, Hospital Clinic of Barcelona, C. de Villarroel, 170, 08036, Barcelona, Spain.
| | - A Gómez-Caamaño
- Department of Radiation Oncology, Hospital Clínico Universitario Santiago de Compostela, 15706, Santiago de Compostela, Spain
| | - Á Cilleruelo-Ramos
- Thoracic Surgery Department, Hospital Clínico Universitario Valladolid, 47005, Valladolid, Spain
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10
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Balasubramanian BA, Higashi RT, Rodriguez SA, Sadeghi N, Santini NO, Lee SC. Thematic Analysis of Challenges of Care Coordination for Underinsured and Uninsured Cancer Survivors With Chronic Conditions. JAMA Netw Open 2021; 4:e2119080. [PMID: 34387681 PMCID: PMC8363913 DOI: 10.1001/jamanetworkopen.2021.19080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
IMPORTANCE Although a majority of underinsured and uninsured patients with cancer have multiple comorbidities, many lack consistent connections with a primary care team to manage chronic conditions during and after cancer treatment. This presents a major challenge to delivering high-quality comprehensive and coordinated care. OBJECTIVE To describe challenges and opportunities for coordinating care in an integrated safety-net system for patients with both cancer and other chronic conditions. DESIGN, SETTING, AND PARTICIPANTS This multimodal qualitative study was conducted from May 2016 to July 2019 at a county-funded, vertically integrated safety-net health system including ambulatory oncology, urgent care, primary care, and specialty care. Participants were 93 health system stakeholders (clinicians, leaders, clinical, and administrative staff) strategically and snowball sampled for semistructured interviews and observation during meetings and daily processes of care. Data collection and analysis were conducted iteratively using a grounded theory approach, followed by systematic thematic analysis to organize data, review, and interpret comprehensive findings. Data were analyzed from March 2019 to March 2020. MAIN OUTCOMES AND MEASURES Multilevel factors associated with experiences of coordinating care for patients with cancer and chronic conditions among oncology and primary care stakeholders. RESULTS Among interviews and observation of 93 health system stakeholders, system-level factors identified as being associated with care coordination included challenges to accessing primary care, lack of communication between oncology and primary care clinicians, and leadership awareness of care coordination challenges. Clinician-level factors included unclear role delineation and lack of clinician knowledge and preparedness to manage the effects of cancer and chronic conditions. CONCLUSIONS AND RELEVANCE Primary care may play a critical role in delivering coordinated care for patients with cancer and chronic diseases. This study's findings suggest a need for care delivery strategies that bridge oncology and primary care by enhancing communication, better delineating roles and responsibilities across care teams, and improving clinician knowledge and preparedness to care for patients with cancer and chronic conditions. Expanding timely access to primary care is also key, albeit challenging in resource-limited safety-net settings.
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Affiliation(s)
- Bijal A. Balasubramanian
- University of Texas Health Science Center at Houston (UTHealth) School of Public Health, Dallas
- Harold C. Simmons Comprehensive Cancer Center, Dallas, Texas
| | - Robin T. Higashi
- Harold C. Simmons Comprehensive Cancer Center, Dallas, Texas
- University of Texas Southwestern Medical Center, Dallas
| | | | - Navid Sadeghi
- Harold C. Simmons Comprehensive Cancer Center, Dallas, Texas
- University of Texas Southwestern Medical Center, Dallas
- Parkland Health and Hospital System, Dallas, Texas
| | | | - Simon Craddock Lee
- Harold C. Simmons Comprehensive Cancer Center, Dallas, Texas
- University of Texas Southwestern Medical Center, Dallas
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Cornelius LA, Fields RC, Tarhini A. Multidisciplinary Care of BRAF-Mutant Stage III Melanoma: A Physicians Perspective Review. Oncologist 2021; 26:e1644-e1651. [PMID: 34080754 PMCID: PMC8417868 DOI: 10.1002/onco.13852] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 05/21/2021] [Indexed: 11/19/2022] Open
Abstract
Prognosis among patients with stage III melanoma can vary widely depending on the risk of disease relapse. Therefore, it is vital to optimize patient care through accurate diagnosis and staging as well as thoughtful treatment planning. A multidisciplinary team (MDT) approach, which involves active collaboration among physician specialists across a patient's disease journey, has been increasingly adopted as the standard of care for treatment of a variety of cancers, including melanoma. This review provides an overview of MDT care principles for patients with BRAF‐mutant–positive, stage III cutaneous melanoma and summarizes current literature, clinical experiences, and institutional best practices. Therapeutic goals from dermatologic, surgical, and medical oncologist perspectives regarding MDT care throughout a patient's disease course are discussed. Additionally, the role of each specialty's involvement in testing for predictive biomarkers at relevant time points to facilitate informed treatment decisions is discussed. Last, instances of successful MDT treatment of other cancers and key lessons to optimize MDT patient care in cutaneous melanoma are provided. Several aspects of MDT patient care are considered vital, such as the importance of staging via pathological examination and imaging, biomarker testing, and interdisciplinary physician and patient engagement throughout the course of treatment. Use of MDTs has the potential to improve patient care in cutaneous melanoma by improving the speed and accuracy of diagnosis, implementing a personalized treatment plan early on, and being proactive in adverse event management. Physician perspectives described in this review may lead to better outcomes, quality of life, and overall patient satisfaction. A multidisciplinary team (MDT) approach has been increasingly adopted as the standard of care for treatment of a variety of cancers, including melanoma. This review provides an overview of MDT care principles for patients with BRAF‐mutant–positive, stage III cutaneous melanoma and summarizes current literature, clinical experiences, and institutional best practices.
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Affiliation(s)
- Lynn A Cornelius
- Division of Dermatology, Department of Medicine, Alvin J. Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St Louis, Missouri, USA
| | - Ryan C Fields
- Department of Surgery, Alvin J. Siteman Cancer Center, Barnes-Jewish Hospital and Washington University School of Medicine, St Louis, Missouri, USA
| | - Ahmad Tarhini
- Departments of Cutaneous Oncology and Immunology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.,University of South Florida Morsani College of Medicine, Tampa, Florida, USA
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12
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Göker E, Altwairgi A, Al-Omair A, Tfayli A, Black E, Elsayed H, Selek U, Koegelenberg C. Multi-disciplinary approach for the management of non-metastatic non-small cell lung cancer in the Middle East and Africa: Expert panel recommendations. Lung Cancer 2021; 158:60-73. [PMID: 34119934 DOI: 10.1016/j.lungcan.2021.05.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 05/20/2021] [Accepted: 05/23/2021] [Indexed: 12/25/2022]
Abstract
The Middle East and Africa (MEA) region, a large geographical area, lies at the confluence of Asian, Caucasian and African races and comprises of a population with several distinct ethnicities. The course of management of non-small cell lung cancer (NSCLC) differs as per patients' performance status as well as stage of disease, requiring personalized therapy decisions. Although management of NSCLC has received a significant impetus in the form of molecularly targeted therapies and immune therapies in last few years, surgery remains gold standard for patients with early-stage disease. In case of unresectable disease, radiotherapy and chemotherapy are the primary management modalities. With newer therapies being approved for treatment of early stage disease, use of multi-disciplinary team (MDT) for comprehensive management of NSCLC is of prime importance. A group of experts with interest in thoracic oncology, deliberated and arrived at a consensus statement for the community oncologists treating patients with NSCLC in the MEA region. The deliberation was based on the review of the published evidence including literature and global and local guidelines, subject expertise of the participating panellists and experience in real-life management of patients with NSCLC. We present the proposed regional adaptations of international guidelines and recommends the MDT approach for management of NSCLC in MEA.
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Affiliation(s)
- Erdem Göker
- Medical Oncology Dept., Ege University, Izmir, Turkey.
| | | | - Ameen Al-Omair
- Radiation Oncology, Oncology Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.
| | - Arafat Tfayli
- Department of Internal Medicine, American University of Beirut, Beirut, Lebanon.
| | - Edward Black
- Department of Thoracic Surgery, Sheikh Shakhbout Medical City, P.O. Box 11001, Abu Dhabi, United Arab Emirates.
| | - Hany Elsayed
- Department of Thoracic Surgery, Ain Shams University, Cairo, Egypt.
| | - Ugur Selek
- Department of Radiation Oncology, Koc University School of Medicine, Koc University, Istanbul, Turkey.
| | - Coenraad Koegelenberg
- Division of Pulmonology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa.
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Zhong XM, Wen XH, Ji CH, Fei XZ, Zhao XG. A temporary-sustainable team: A new multidisciplinary team model for severe trauma. Chin J Traumatol 2020; 23:363-366. [PMID: 33214008 PMCID: PMC7718525 DOI: 10.1016/j.cjtee.2020.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 05/30/2020] [Accepted: 07/31/2020] [Indexed: 02/04/2023] Open
Abstract
The treatment of severe trauma, especially multiple injuries, requires multidisciplinary collaboration. The current study aims to highlight the challenges of consultation mode for severe trauma in general hospitals and emphasizes the need to create a new temporary-sustainable team. It suggests developing an information consultation mode and enforcing the fine management to improve the quality and safety of the medical treatment. The management mode of a temporary-sustainable team will reduce the cost and improve the treatment efficiency. Overall, a temporary-sustainable team has significant advantages over a traditional multidisciplinary team for severe trauma treatment.
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Affiliation(s)
- Xing-Ming Zhong
- Department of Emergency and Department of Neurosurgery, The First People's Hospital of Huzhou, First Affiliated Hospital of Huzhou Normal University, Huzhou 313000, Zhejiang Province, China
| | - Xiao-Hong Wen
- Department of Emergency and Department of Neurosurgery, The First People's Hospital of Huzhou, First Affiliated Hospital of Huzhou Normal University, Huzhou 313000, Zhejiang Province, China,Corresponding author.
| | - Chao-Hui Ji
- Department of Emergency and Department of Neurosurgery, The First People's Hospital of Huzhou, First Affiliated Hospital of Huzhou Normal University, Huzhou 313000, Zhejiang Province, China
| | - Xing-Zhen Fei
- Department of Emergency and Department of Neurosurgery, The First People's Hospital of Huzhou, First Affiliated Hospital of Huzhou Normal University, Huzhou 313000, Zhejiang Province, China
| | - Xiao-Gang Zhao
- Department of Emergency, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
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14
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Hung HY, Tseng YH, Chao HS, Chiu CH, Hsu WH, Hsu HS, Wu YC, Chou TY, Chen CK, Lan KL, Chen YW, Wu YH, Chen YM. Multidisciplinary team discussion results in survival benefit for patients with stage III non-small-cell lung cancer. PLoS One 2020; 15:e0236503. [PMID: 33031375 PMCID: PMC7544080 DOI: 10.1371/journal.pone.0236503] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 07/07/2020] [Indexed: 12/25/2022] Open
Abstract
Background The treatment for stage III non-small cell lung cancer (NSCLC) often involves multi-modality treatment. This retrospective study aimed to evaluate whether multidisciplinary team (MDT) discussion results in better patient survival. Materials and methods MDT discussion was optional before February 2016 and was actively encouraged by the MDT committee beginning February 2016. We reviewed the medical charts and computer records of patients with stage III NSCLC between January 2013 and December 2018. Results A total of 515 patients were included. The median survival of all the patients was 33.9 months (M). The median survival of patients who were treated after MDT discussion was 41.2 M and that of patients treated without MDT discussion was 25.7 M (p = 0.018). The median survival of patients treated before February 2016 was 25.7 M and that of patients treated after February 2016 was 33.9 M (p = 0.003). The median survival of patients with stage IIIA tumors and those with stage IIIB tumors was 39.4 M and 25.7 M, respectively (p = 0.141). Multivariate analysis showed that MDT or not (p<0.001), T staging (p = 0.009), performance status (p<0.001), and surgery (p = 0.016) to be significant prognostic factors. Conclusion The results of the study show that MDT discussion results in survival benefit in patients with stage III NSCLC. The MDT discussion, performance status, and if surgery was performed were independent prognostic factors for patients with stage III NSCLC.
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Affiliation(s)
- Hsiu-Ying Hung
- Nursing Department, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yen-Han Tseng
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China (R.O.C)
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C
| | - Heng-Sheng Chao
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China (R.O.C)
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C
| | - Chao-Hua Chiu
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China (R.O.C)
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C
| | - Wen-Hu Hsu
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C
- Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C
| | - Han-Shui Hsu
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C
- Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C
| | - Yu-Chung Wu
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C
- Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C
| | - Teh-Ying Chou
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C
- Division of Molecular Pathology, Department of Pathology and Laboratory Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C
| | - Chun-Ku Chen
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C
| | - Keng-Li Lan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C
- Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yi-Wei Chen
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C
- Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yuan-Hung Wu
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C
- Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yuh-Min Chen
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China (R.O.C)
- School of Medicine, National Yang-Ming University, Taipei, Taiwan, R.O.C
- Taipei Cancer Center, Taipei Medical University, Taipei, Taiwan, R.O.C
- * E-mail:
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15
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Al Zaidi M, Wright GM. Locally advanced non-small cell lung cancer: the place of specialist thoracic surgery in the multidisciplinary team. Transl Lung Cancer Res 2020; 9:1680-1689. [PMID: 32953541 PMCID: PMC7481639 DOI: 10.21037/tlcr.2019.11.22] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
One reason that lung cancer is the leading cause of cancer mortality worldwide, is that surgical intervention is highly dependent on earlier tumor stage and good patient condition. As large proportion of cases are already metastatic at presentation and many are locally advanced, curative surgery is only possible in a minority of fit patients. Increasing the number of patients achieving complete resection is one of the avenues to increase overall survival using our existing technology. In the past, complex cases may have been sporadically discussed between various specialists in order to achieve better outcomes. More recently, the idea of discussing those cases on a routine basis, rather than an accident of geography or referral pattern, gave rise to the multidisciplinary team. Lung cancer management is now increasingly complex, especially with novel modalities such as targeted therapies, immune checkpoint inhibitors and stereotactic body radiotherapy delivery. Likewise, in thoracic surgery, minimally invasive techniques, early recovery after surgery protocols and complex techniques for resecting locally advanced tumours or preserving lung parenchyma must all be deployed appropriately to continue our incremental gains in survival and quality of life. To highlight the role of specialist thoracic surgeon in the multidisciplinary care of locally advanced non-small cell lung cancer, we conducted a search of English language publications for its multidisciplinary-based surgical management. We limited our search to the last decade, then hand-searched relevant references. In addition, we used our large prospective database as a team-oriented specialized thoracic surgical service to benchmark and demonstrate the benefits of specialist surgeons in the modern multidisciplinary team. In conclusion, patients with locally advanced non-small cell lung cancer should have any surgical option withheld without a specialist thoracic surgical opinion as part of the multidisciplinary team discussion.
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Affiliation(s)
- Muteb Al Zaidi
- Department of Cardiothoracic Surgery, St. Vincent's Hospital (Melbourne), University of Melbourne, Fitzroy, Victoria, Australia.,Division of Thoracic Surgery, King Abdullah Medical City, Makkah, Saudi Arabia
| | - Gavin M Wright
- Department of Surgery, St. Vincent's Hospital (Melbourne), University of Melbourne, Fitzroy, Victoria, Australia.,Victorian Comprehensive Cancer Centre, Parkville, Victoria, Australia.,Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Parkville, Victoria, Australia
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16
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Berghmans T, Lievens Y, Aapro M, Baird AM, Beishon M, Calabrese F, Dégi C, Delgado Bolton RC, Gaga M, Lövey J, Luciani A, Pereira P, Prosch H, Saar M, Shackcloth M, Tabak-Houwaard G, Costa A, Poortmans P. European Cancer Organisation Essential Requirements for Quality Cancer Care (ERQCC): Lung cancer. Lung Cancer 2020; 150:221-239. [PMID: 33227525 DOI: 10.1016/j.lungcan.2020.08.017] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 08/26/2020] [Indexed: 12/24/2022]
Abstract
European Cancer Organisation Essential Requirements for Quality Cancer Care (ERQCC) are written by experts representing all disciplines involved in cancer care in Europe. They give patients, health professionals, managers and policymakers a guide to essential care throughout the patient journey. Lung cancer is the leading cause of cancer mortality and has a wide variation in treatment and outcomes in Europe. It is a major healthcare burden and has complex diagnosis and treatment challenges. Care must only be carried out in lung cancer units or centres that have a core multidisciplinary team (MDT) and an extended team of health professionals detailed here. Such units are far from universal in European countries. To meet European aspirations for comprehensive cancer control, healthcare organisations must consider the requirements in this paper, paying particular attention to multidisciplinarity and patient-centred pathways from diagnosis, to treatment, to survivorship.
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Affiliation(s)
- Thierry Berghmans
- European Organisation for Research and Treatment of Cancer (EORTC); Thoracic Oncology Clinic, Institut Jules Bordet, Brussels, Belgium
| | - Yolande Lievens
- European Society for Radiotherapy and Oncology (ESTRO); Radiation Oncology Department, Ghent University Hospital, Belgium
| | - Matti Aapro
- European Cancer Organisation; Genolier Cancer Center, Genolier, Switzerland
| | - Anne-Marie Baird
- European Cancer Organisation Patient Advisory Committee; Central Pathology Laboratory, St James's Hospital, Dublin, Ireland
| | - Marc Beishon
- Cancer World, European School of Oncology (ESO), Milan, Italy.
| | - Fiorella Calabrese
- European Society of Pathology (ESP); Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova Medical School, Padova, Italy
| | - Csaba Dégi
- International Psycho-Oncology Society (IPOS); Faculty of Sociology and Social Work, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Roberto C Delgado Bolton
- European Association of Nuclear Medicine (EANM); Department of Diagnostic Imaging (Radiology) and Nuclear Medicine, San Pedro Hospital and Centre for Biomedical Research of La Rioja (CIBIR); University of La Rioja, Logroño, La Rioja, Spain
| | - Mina Gaga
- European Respiratory Society (ERS); 7th Respiratory Medicine Department, Athens Chest Hospital Sotiria, Athens, Greece
| | - József Lövey
- Organisation of European Cancer Institutes (OECI); National Institute of Oncology, Budapest, Hungary
| | - Andrea Luciani
- International Society of Geriatric Oncology (SIOG); Medical Oncology, Ospedale S. Paolo, Milan, Italy
| | - Philippe Pereira
- Cardiovascular and Interventional Radiological Society of Europe (CIRSE); Clinic for Radiology, Minimally-Invasive Therapies and Nuclear Medicine, SLK-Kliniken, Heilbronn, Germany
| | - Helmut Prosch
- European Society of Radiology (ESR); Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Austria
| | - Marika Saar
- European Society of Oncology Pharmacy (ESOP); Tartu University Hospital, Tartu, Estonia
| | - Michael Shackcloth
- European Society of Surgical Oncology (ESSO); Department of Thoracic Surgery, Liverpool Heart and Chest Hospital, Liverpool, United Kingdom
| | | | | | - Philip Poortmans
- European Cancer Organisation; Iridium Kankernetwerk and University of Antwerp, Wilrijk-Antwerp, Belgium
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17
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Dlamini Z, Francies FZ, Hull R, Marima R. Artificial intelligence (AI) and big data in cancer and precision oncology. Comput Struct Biotechnol J 2020; 18:2300-2311. [PMID: 32994889 PMCID: PMC7490765 DOI: 10.1016/j.csbj.2020.08.019] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 08/21/2020] [Accepted: 08/21/2020] [Indexed: 02/07/2023] Open
Abstract
Artificial intelligence (AI) and machine learning have significantly influenced many facets of the healthcare sector. Advancement in technology has paved the way for analysis of big datasets in a cost- and time-effective manner. Clinical oncology and research are reaping the benefits of AI. The burden of cancer is a global phenomenon. Efforts to reduce mortality rates requires early diagnosis for effective therapeutic interventions. However, metastatic and recurrent cancers evolve and acquire drug resistance. It is imperative to detect novel biomarkers that induce drug resistance and identify therapeutic targets to enhance treatment regimes. The introduction of the next generation sequencing (NGS) platforms address these demands, has revolutionised the future of precision oncology. NGS offers several clinical applications that are important for risk predictor, early detection of disease, diagnosis by sequencing and medical imaging, accurate prognosis, biomarker identification and identification of therapeutic targets for novel drug discovery. NGS generates large datasets that demand specialised bioinformatics resources to analyse the data that is relevant and clinically significant. Through these applications of AI, cancer diagnostics and prognostic prediction are enhanced with NGS and medical imaging that delivers high resolution images. Regardless of the improvements in technology, AI has some challenges and limitations, and the clinical application of NGS remains to be validated. By continuing to enhance the progression of innovation and technology, the future of AI and precision oncology show great promise.
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Affiliation(s)
- Zodwa Dlamini
- SAMRC/UP Precision Prevention & Novel Drug Targets for HIV-Associated Cancers (PPNDTHAC) Extramural Unit, Pan African Cancer Research Institute (PACRI), University of Pretoria, Faculty of Health Sciences, Hatfield 0028, South Africa
| | - Flavia Zita Francies
- SAMRC/UP Precision Prevention & Novel Drug Targets for HIV-Associated Cancers (PPNDTHAC) Extramural Unit, Pan African Cancer Research Institute (PACRI), University of Pretoria, Faculty of Health Sciences, Hatfield 0028, South Africa
| | - Rodney Hull
- SAMRC/UP Precision Prevention & Novel Drug Targets for HIV-Associated Cancers (PPNDTHAC) Extramural Unit, Pan African Cancer Research Institute (PACRI), University of Pretoria, Faculty of Health Sciences, Hatfield 0028, South Africa
| | - Rahaba Marima
- SAMRC/UP Precision Prevention & Novel Drug Targets for HIV-Associated Cancers (PPNDTHAC) Extramural Unit, Pan African Cancer Research Institute (PACRI), University of Pretoria, Faculty of Health Sciences, Hatfield 0028, South Africa
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18
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Abstract
Lung cancer is the most common cause of cancer mortality globally. A vast majority of lung cancer cases are diagnosed at advanced stages. Management of advanced lung cancer requires several diagnostic and therapeutic procedures provided by various specialists. To optimise the entire diagnostic and therapeutic process, a concept of care provided simultaneously by a multidisciplinary team (MDT) has been developed and implemented in specialised centres worldwide. Observational studies suggest that integrated and coordinated care increases adherence to clinical guidelines, significantly shortens the interval from diagnosis to treatment, and may increase survival and quality of life (QoL). Prospective studies are warranted to assess the real impact of MDT on treatment outcomes and to further refine this approach.
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Affiliation(s)
- Anna Kowalczyk
- Department of Oncology and Radiotherapy, Medical University of Gdansk, Gdansk, Poland
| | - Jacek Jassem
- Department of Oncology and Radiotherapy, Medical University of Gdansk, Gdansk, Poland
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19
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Karas PL, Rankin NM, Stone E. Medicolegal Considerations in Multidisciplinary Cancer Care. JTO Clin Res Rep 2020; 1:100073. [PMID: 33225316 PMCID: PMC7333617 DOI: 10.1016/j.jtocrr.2020.100073] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/21/2020] [Accepted: 06/22/2020] [Indexed: 12/29/2022] Open
Abstract
Health professionals participating in multidisciplinary team (MDT) cancer meetings may not be aware of their medicolegal obligations. This commentary aims to identify medicolegal issues concerning multidisciplinary cancer care and provides recommendations for future implementation. Predominant medicolegal issues related to MDT care were identified in the literature; these include patient consent and privacy at MDT meetings, professional liability, formal expression of dissenting views, and duty of care. Analysis of the literature prioritizes several recommendations for managing these issues. With limited precedent on which to base recommendations, this article identifies the formative evidence that may guide the management of these issues in future MDT practice.
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Affiliation(s)
- Pamela L Karas
- Kinghorn Cancer Centre, St Vincent's Hospital Sydney, University of New South Wales, Darlinghurst, New South Wales, Australia
| | - Nicole M Rankin
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Emily Stone
- Kinghorn Cancer Centre, St Vincent's Hospital Sydney, University of New South Wales, Darlinghurst, New South Wales, Australia.,Department of Thoracic Medicine, St Vincent's Hospital Sydney, University of New South Wales, Darlinghurst, New South Wales, Australia
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20
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Management of incidental pulmonary nodule in CT: a survey by the Italian College of Chest Radiology. Radiol Med 2019; 124:602-612. [DOI: 10.1007/s11547-019-01011-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 02/21/2019] [Indexed: 12/19/2022]
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21
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Zhang Q, Qu Y, Liu H, Jia H, Wen F, Pei S, Yu H. Initial platelet-to-lymphocyte count as prognostic factor in limited-stage small cell lung cancer. Biomark Med 2019; 13:249-258. [PMID: 30624082 DOI: 10.2217/bmm-2018-0415] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Aim: To assessed the prognostic significance of pretreatment platelet-to-lymphocyte ratio (PLR) in patients with limited-stage small cell lung cancer (LS-SCLC). Methods: We retrospectively analyzed 286 patients with LS-SCLC. Results: Sixty received chemotherapy alone, 158 sequential chemo- and radiotherapy, 38 concurrent chemo- and radiotherapy and 30 surgery combined with therapy. The cut-off value of pretreatment PLR was 152.1. The median progression free survival (PFS) and overall survival (OS) in the low and high PLR groups were 27.4 versus 19.5 (p = 0.002) and 14.9 versus 11.4 (p = 0.003) months. Multivariate analysis confirmed that PLR was an independent prognostic factor of OS (hazard ratio = 1.326; p = 0.040) and PFS (hazard ratio = 1.306; p = 0.044), respectively. Conclusion: Pretreatment PLR is an independent prognostic factor of OS and PFS in patients with LS-SCLC.
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Affiliation(s)
- Qing Zhang
- Radiation Oncology Department of Thoracic Cancer, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Liaoning, Shenyang 110042, PR China
| | - Yanli Qu
- Radiation Oncology Department of Thoracic Cancer, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Liaoning, Shenyang 110042, PR China
| | - Hangyu Liu
- Radiation Oncology Department of Thoracic Cancer, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Liaoning, Shenyang 110042, PR China
| | - Hongying Jia
- Radiation Oncology Department of Thoracic Cancer, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Liaoning, Shenyang 110042, PR China
| | - Fengyun Wen
- Radiation Oncology Department of Thoracic Cancer, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Liaoning, Shenyang 110042, PR China
| | - Shengnan Pei
- Radiation Oncology Department of Thoracic Cancer, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Liaoning, Shenyang 110042, PR China
| | - Hong Yu
- Radiation Oncology Department of Thoracic Cancer, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Liaoning, Shenyang 110042, PR China
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22
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Rich AL, Baldwin DR, Beckett P, Berghmans T, Boyd J, Faivre-Finn C, Galateau-Salle F, Gamarra F, Grigoriu B, Hansen NCG, Hardavella G, Jakobsen E, Jovanovic D, Konsoulova A, Massard G, McPhelim J, Meert AP, Milroy R, Mutti L, Paesmans M, Peake MD, Putora PM, de Ruysscher DK, Sculier JP, Schepereel A, Subotic DR, Van Schil P, Blum T. ERS statement on harmonised standards for lung cancer registration and lung cancer services in Europe. Eur Respir J 2018; 52:13993003.00610-2018. [DOI: 10.1183/13993003.00610-2018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 07/03/2018] [Indexed: 12/25/2022]
Abstract
The European Respiratory Society (ERS) task force for harmonised standards for lung cancer registration and lung cancer services in Europe recognised the need to create a single dataset for use in pan-European data collection and a manual of standards for European lung cancer services.The multidisciplinary task force considered evidence from two different sources, reviewing existing national and international datasets alongside the results of a survey of clinical data collection on lung cancer in 35 European countries. A similar process was followed for the manual of lung cancer services, with the task force using existing guidelines and national or international recommendations for lung cancer services to develop a manual of standards for services in Europe.The task force developed essential and minimum datasets for lung cancer registration to enable all countries to collect the same essential data and some to collect data with greater detail. The task force also developed a manual specifying standards for lung cancer services in Europe.Despite the wide variation in the sociopolitical landscape across Europe, the ERS is determined to encourage the delivery of high-quality lung cancer care. Both the manual of lung cancer services and the minimum dataset for lung cancer registration will support this aspiration.
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23
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Turner A, Mulla A, Booth A, Aldridge S, Stevens S, Begum M, Malik A. The international knowledge base for new care models relevant to primary care-led integrated models: a realist synthesis. HEALTH SERVICES AND DELIVERY RESEARCH 2018. [PMID: 29972636 DOI: 10.3310/hsdr06250] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BackgroundThe Multispecialty Community Provider (MCP) model was introduced to the NHS as a primary care-led, community-based integrated care model to provide better quality, experience and value for local populations.ObjectivesThe three main objectives were to (1) articulate the underlying programme theories for the MCP model of care; (2) identify sources of theoretical, empirical and practice evidence to test the programme theories; and (3) explain how mechanisms used in different contexts contribute to outcomes and process variables.DesignThere were three main phases: (1) identification of programme theories from logic models of MCP vanguards, prioritising key theories for investigation; (2) appraisal, extraction and analysis of evidence against a best-fit framework; and (3) realist reviews of prioritised theory components and maps of remaining theory components.Main outcome measuresThe quadruple aim outcomes addressed population health, cost-effectiveness, patient experience and staff experience.Data sourcesSearches of electronic databases with forward- and backward-citation tracking, identifying research-based evidence and practice-derived evidence.Review methodsA realist synthesis was used to identify, test and refine the following programme theory components: (1) community-based, co-ordinated care is more accessible; (2) place-based contracting and payment systems incentivise shared accountability; and (3) fostering relational behaviours builds resilience within communities.ResultsDelivery of a MCP model requires professional and service user engagement, which is dependent on building trust and empowerment. These are generated if values and incentives for new ways of working are aligned and there are opportunities for training and development. Together, these can facilitate accountability at the individual, community and system levels. The evidence base relating to these theory components was, for the most part, limited by initiatives that are relatively new or not formally evaluated. Support for the programme theory components varies, with moderate support for enhanced primary care and community involvement in care, and relatively weak support for new contracting models.Strengths and limitationsThe project benefited from a close relationship with national and local MCP leads, reflecting the value of the proximity of the research team to decision-makers. Our use of logic models to identify theories of change could present a relatively static position for what is a dynamic programme of change.ConclusionsMultispecialty Community Providers can be described as complex adaptive systems (CASs) and, as such, connectivity, feedback loops, system learning and adaptation of CASs play a critical role in their design. Implementation can be further reinforced by paying attention to contextual factors that influence behaviour change, in order to support more integrated working.Future workA set of evidence-derived ‘key ingredients’ has been compiled to inform the design and delivery of future iterations of population health-based models of care. Suggested priorities for future research include the impact of enhanced primary care on the workforce, the effects of longer-term contracts on sustainability and capacity, the conditions needed for successful continuous improvement and learning, the role of carers in patient empowerment and how community participation might contribute to community resilience.Study registrationThis study is registered as PROSPERO CRD42016039552.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
- Alison Turner
- The Strategy Unit, NHS Midlands and Lancashire Commissioning Support Unit, West Bromwich, UK
| | - Abeda Mulla
- The Strategy Unit, NHS Midlands and Lancashire Commissioning Support Unit, West Bromwich, UK
| | - Andrew Booth
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Shiona Aldridge
- The Strategy Unit, NHS Midlands and Lancashire Commissioning Support Unit, West Bromwich, UK
| | - Sharon Stevens
- The Strategy Unit, NHS Midlands and Lancashire Commissioning Support Unit, West Bromwich, UK
| | - Mahmoda Begum
- The Strategy Unit, NHS Midlands and Lancashire Commissioning Support Unit, West Bromwich, UK
| | - Anam Malik
- The Strategy Unit, NHS Midlands and Lancashire Commissioning Support Unit, West Bromwich, UK
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Dantes E, Tofolean DE, Fildan AP, Mazilu L, Gogonea I, Dumitrache-Rujinski S, Arghir OC. Prognostic Intake of Molecular Markers in Lung Cancer The Pulmonologist Point Of View. ARS MEDICA TOMITANA 2017. [DOI: 10.1515/arsm-2017-0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Lung cancer remains one of the most frequent pathologies in Pulmonology Departments. Tumor extension, histopathological types, and treatment influence the prognosis and survival in lung cancer. Five years survival dramatically decreases for the 4th-stage of the disease. Non-small cell lung cancer (NSCLC) represents the vast majority of lung cancers. In the last decades, important findings have been made on identifying standardized molecular biomarkers that control tumor growth in lung adenocarcinoma. The discovery of new drugs led to the increased survival, even in extensive forms of the disease. The greatest advances could be obtained by targeting EGFR genetic mutations or EML4-ALK translocate in patients diagnosed with adenocarcinoma lung cancer
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Affiliation(s)
- Elena Dantes
- Faculty of Medicine, “Ovidius” University of Constanta , Romania
- Clinical Pulmonology Hospital of Constanta , Romania
| | - Doina Ecaterina Tofolean
- Faculty of Medicine, “Ovidius” University of Constanta , Romania
- Clinical Pulmonology Hospital of Constanta , Romania
| | - Ariadna Petronela Fildan
- Faculty of Medicine, “Ovidius” University of Constanta , Romania
- Clinical Pulmonology Hospital of Constanta , Romania
| | - Laura Mazilu
- Faculty of Medicine, “Ovidius” University of Constanta , Romania
- Oncology Department of Clinical Emergency Hospital of Constanta , Romania
| | - Ioana Gogonea
- Pulmonology Department of Clinical Emergency Hospital of Constanta , Romania
| | - S. Dumitrache-Rujinski
- Carol Davila University of Medicine and Pharmacy, Department of Pneumology Bucharest , Romania
| | - Oana Cristina Arghir
- Faculty of Medicine, “Ovidius” University of Constanta , Romania
- Clinical Pulmonology Hospital of Constanta , Romania
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Zou H, Luo L, Xue H, Wang G, Wang X, Luo L, Yao Y, Xiang G, Huang X. Preliminary experience in laparoscopic resection of hepatic hydatidectocyst with the Da Vinci Surgical System (DVSS): a case report. BMC Surg 2017; 17:98. [PMID: 28893209 PMCID: PMC5594609 DOI: 10.1186/s12893-017-0294-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 09/01/2017] [Indexed: 02/07/2023] Open
Abstract
Background At present, Da Vinci robotic assisted hepatectomy has been routinely carried out in conditional units. But there is no report concerning the use of Da Vinci robots for hepatic hydatid cystectomy and experience on this aspect is seldom mentioned before. This study was to summarize the preliminary experience in laparoscopic resection of hepatic hydatidectocyst with the Da Vinci Surgical System (DVSS). Case presentation A 29-year-old female diagnosed as hepatic hydatid in the right anterior lobe of liver was treated with laparoscopic resection by the DVSS under general anesthesia. Appropriate disposal of tumor cell in vascular system and disinfection of surgical field with hypertonic saline were conducted. The hepatic hydatidectocyst was resected completely with an operation time of 130 min, an intraoperative blood loss of 200 ml and a length of hospital stay for five days. The vital signs of patient were stable and no cyst fluid allergy occurred after operation. Conclusions Our result showed that laparoscopic resection of hepatic hydatidectocyst by using the DVSS is safe and feasible on the basis of hospitals have rich experience in treatment of cystic echinococcosisliver, resection with DVSS and laparoscopic excision.
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Affiliation(s)
- Haibo Zou
- Department of Hepatobiliary Surgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, #32, Section 2, West 1st Ring Road, Chengdu, 610072, China
| | - Lanyun Luo
- Department of Hepatobiliary Surgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, #32, Section 2, West 1st Ring Road, Chengdu, 610072, China
| | - Hua Xue
- Department of Hepatobiliary Surgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, #32, Section 2, West 1st Ring Road, Chengdu, 610072, China
| | - Guan Wang
- Department of Hepatobiliary Surgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, #32, Section 2, West 1st Ring Road, Chengdu, 610072, China.
| | - Xiankui Wang
- Department of Hepatobiliary Surgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, #32, Section 2, West 1st Ring Road, Chengdu, 610072, China
| | - Le Luo
- Department of Hepatobiliary Surgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, #32, Section 2, West 1st Ring Road, Chengdu, 610072, China
| | - Yutong Yao
- Department of Hepatobiliary Surgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, #32, Section 2, West 1st Ring Road, Chengdu, 610072, China
| | - Guangming Xiang
- Department of Hepatobiliary Surgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, #32, Section 2, West 1st Ring Road, Chengdu, 610072, China
| | - Xiaolun Huang
- Department of Hepatobiliary Surgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, #32, Section 2, West 1st Ring Road, Chengdu, 610072, China
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Glatzer M, Rittmeyer A, Müller J, Opitz I, Papachristofilou A, Psallidas I, Früh M, Born D, Putora PM. Treatment of limited disease small cell lung cancer: the multidisciplinary team. Eur Respir J 2017; 50:50/2/1700422. [PMID: 28838979 DOI: 10.1183/13993003.00422-2017] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 05/16/2017] [Indexed: 12/17/2022]
Abstract
Small cell lung cancer (SCLC) presents multiple interdisciplinary challenges with several paradigm shifts in its treatment in recent years. SCLC treatment requires multidisciplinary management and timely treatment. The aim of this review is to focus on the team management aspects in the treatment of limited disease SCLC and how this can contribute towards improving outcomes.
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Affiliation(s)
- Markus Glatzer
- Dept of Radiation Oncology, Kantonsspital St Gallen, St Gallen, Switzerland
| | - Achim Rittmeyer
- Dept of Thoracic Oncology, Lungenfachklinik Immenhausen, Immenhausen, Germany
| | - Joachim Müller
- Dept of Radiology and Nuclear Medicine, Kantonsspital St Gallen, St Gallen, Switzerland
| | - Isabelle Opitz
- Dept of Thoracic Surgery, University Hospital Zürich, Zürich, Switzerland
| | | | - Ioannis Psallidas
- Oxford Centre for Respiratory Medicine, Churchill Hospital, Oxford, UK.,Oxford Respiratory Trials Unit, Churchill Hospital, Oxford, UK
| | - Martin Früh
- Dept of Oncology and Haematology, Kantonsspital St Gallen, St Gallen, Switzerland
| | - Diana Born
- Institute of Pathology, Kantonsspital St Gallen, St Gallen, Switzerland
| | - Paul Martin Putora
- Dept of Radiation Oncology, Kantonsspital St Gallen, St Gallen, Switzerland
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Jimenez MF, Novoa NM, Varela G. Surgery Versus Stereotactic Body Radiotherapy for Resectable Lung Cancer. CURRENT SURGERY REPORTS 2016. [DOI: 10.1007/s40137-016-0162-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Varela G, Gómez-Hernández MT. Stereotactic ablative radiotherapy for early stage non-small cell lung cancer: a word of caution. Transl Lung Cancer Res 2016; 5:102-5. [PMID: 26958502 DOI: 10.3978/j.issn.2218-6751.2015.10.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Recently published data from pooled randomised trials conclude that stereotactic ablative radiotherapy (SABR) can be considered the treatment of choice in operable lung cancer patients fit for lobectomy. This conclusion comes for comparable 3-year survival and much lower risk of early severe morbidity and mortality. In this editorial comment we discuss the validity of the conclusions due to the prematurity of the survival analysis and to the poor accuracy of patients' staging leading to higher rates of regional relapse in the SABR arm. Besides, therapy-related mortality and morbidity in the pooled cohort is much higher that the internationally accepted standards maybe because surgery was not performed according to the best approaches and procedures currently available. The effectiveness of SABR as the sole therapy for resectable lung cancer is still awaiting for sound evidences. It could be adopted for individual cases only in two situations: (I) the patient does not accept surgical treatment; and (II) in cases were the risk of surgical related mortality is considered to exceed the probability of long-term survival after lung resection. For this, a multidisciplinary team (MDT) assessment, including surgeons and oncologists, is mandatory.
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Affiliation(s)
- Gonzalo Varela
- Thoracic Surgery Service, Salamanca University Hospital and Salamanca's Bio-sanitary Institute (IBSAL), Salamanca, Spain
| | - María Teresa Gómez-Hernández
- Thoracic Surgery Service, Salamanca University Hospital and Salamanca's Bio-sanitary Institute (IBSAL), Salamanca, Spain
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Blum T, Schönfeld N. The lung cancer patient, the pneumologist and palliative care: a developing alliance. Eur Respir J 2014; 45:211-26. [DOI: 10.1183/09031936.00072514] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Considerable evidence is now available on the value of palliative care for lung cancer patients in all stages and at all times during the course of the disease. However, pneumologists and their institutions seem to be widely in arrears with the implementation of palliative care concepts and the development of integrated structures.This review focuses on the available evidence and experience of various frequently unmet needs of lung cancer patients, especially psychological, social, spiritual and cultural ones. A PubMed search for evidence on these aspects of palliative care as well as on barriers to the implementation, on outcome parameters and effectiveness, and on structure and process quality was performed with a special focus on lung cancer patients.As a consequence, this review particularly draws pneumologists’ attention to improving their skills in communication with the patients, their relatives and among themselves, and to establish team structures with more far-reaching competences and continuity than existing multilateral cooperations and conferences can provide. Ideally, any process of structural and procedural improvement should be accompanied by scientific evaluation and measures for quality optimisation.
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