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Description and analysis of clinical pathways for oesophago-gastric adenocarcinoma, in 10 European countries (the EURECCA upper gastro intestinal group - European Registration of Cancer Care)
- Source :
- European journal of surgical oncology, Vol. 42, No 9 (2016) pp. 1432-1447
- Publication Year :
- 2016
-
Abstract
- AIMS: Outcomes for patients with oesophago-gastric cancer are variable across Europe. The reasons for this variability are not clear. The aim of this study was to describe and analyse clinical pathways to understand differences in service provision for oesophageal and gastric cancer in the countries participating in the EURECCA Upper GI group. METHODS: A questionnaire was devised to assess clinical presentation, diagnosis, staging, treatment, pathology, follow-up and service frameworks across Europe for patients with oesophageal and gastric cancer. The questionnaire was issued to experts from 14 countries. The responses were analysed quantitatively and qualitatively and compared. RESULTS: The response rate was (10/14) 71.4%. The approach to diagnosis was similar. Most countries established a diagnosis within 3 weeks of presentation. However, there were different approaches to staging with variable use of endoscopic ultrasound reflecting availability. There has been centralisation of treatments in most countries for oesophageal surgery. The most consistent area was the approach to pathology. There were variations in access to specialist nurse and dietitian support. Although most countries have multidisciplinary teams, their composition and frequency of meetings varied. The two main areas of significant difference were research and audit and overall service provision. Observations on service framework indicated that limited resources restricted many of the services. CONCLUSION: The principle approaches to diagnosis, treatment and pathology were similar. Factors affecting the quality of patient experience were variable. This may reflect availability of resources. Standard pathways of care may enhance both the quality of treatment and patient experience. The 2013 Annual Grant for international mobility from the AFC (French Association of Surgery) was part of the salary of MM.
- Subjects :
- Endoscopic ultrasound
Time Factors
Esophageal Neoplasms
Denmark
030230 surgery
Adenocarcinoma / pathology
Adenocarcinoma / therapy
0302 clinical medicine
Clinical pathway
Multidisciplinary approach
Germany
Surveys and Questionnaires
Registries
Esophageal Neoplasms / pathology
Netherlands
Response rate (survey)
Oncologists
medicine.diagnostic_test
ddc:617
Esophageal Neoplasms / therapy
Oesophageal cancer
Health Policy
Esòfag -- Càncer
General Medicine
Europe
Oncology
Italy
030220 oncology & carcinogenesis
Critical Pathways
EURECCA
France
medicine.medical_specialty
National health policy
Audit
Stomach Neoplasms / diagnosis
Adenocarcinoma
03 medical and health sciences
Adenocarcinoma / diagnosis
Stomach Neoplasms
Patient experience
medicine
Animals
Humans
Intensive care medicine
Health policy
Neoplasm Staging
Quality of Health Care
Patient Care Team
Surgeons
Sweden
Esophageal Neoplasms / diagnosis
Care pathway
business.industry
Gastroenterologists
Cancer
medicine.disease
United Kingdom
Surgery
Spain
Poland
Stomach Neoplasms / therapy
business
Gastric cancer
Stomach Neoplasms / pathology
Ireland
Subjects
Details
- Language :
- English
- ISSN :
- 07487983
- Database :
- OpenAIRE
- Journal :
- European journal of surgical oncology, Vol. 42, No 9 (2016) pp. 1432-1447
- Accession number :
- edsair.doi.dedup.....ebc9d9682fac518903b33c68bbec07a1