An Internet-Based Collaborative Cancer Conference for Rectal Cancer Influenced Surgeon Treatment Recommendations

Introduction In many jurisdictions geographic and resource constraints are barriers to multidisciplinary cancer conference review of all patients undergoing cancer surgery. We piloted an internet-based collaborative cancer conference (I-CCC) for rectal cancer to overcome these barriers in the LHIN4...

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Bibliographic Details
Published in:Annals of surgical oncology 2015-07, Vol.22 (7), p.2143-2150
Main Authors: Francescutti, Valerie, Amin, Nalin, Cadeddu, Margherita, Eskicioglu, Cagla, Forbes, Shawn, Kelly, Stephen, Yang, Ilun, Tsai, Scott, Coates, Angela, Grubac, Vanja, Simunovic, Marko
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Colorectal Cancer
Combined Modality Therapy
Cooperative Behavior
Cross-Sectional Studies
Female
Follow-Up Studies
Humans
Interdisciplinary Communication
Internet
Male
Medicine
Medicine & Public Health
Middle Aged
Neoplasm Staging
Oncology
Patient Care Planning
Patient Care Team
Pilot Projects
Prognosis
Prospective Studies
Rectal Neoplasms - diagnosis
Rectal Neoplasms - therapy
Surgeons
Surgery
Surgical Oncology
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Summary:Introduction In many jurisdictions geographic and resource constraints are barriers to multidisciplinary cancer conference review of all patients undergoing cancer surgery. We piloted an internet-based collaborative cancer conference (I-CCC) for rectal cancer to overcome these barriers in the LHIN4 region of Ontario (population 1.4 million). Methods Surgeons practicing at one of 10 LHIN4 hospitals were invited to participate in I-CCC reviews. A secure internet audio and visual link facilitated review of cross-sectional images and case details. Before review, referring surgeons detailed initial treatment plans. Main treatment options included preoperative radiation, straight to surgery, and plan uncertain. Changes were noted following I-CCC review from initial to final treatment plan. Major changes included: redirect patient to preoperative radiation from straight to surgery or plan uncertain; and redirect patient to straight to surgery from preoperative radiation or plan uncertain. Minor changes included: change type of neoadjuvant therapy; request additional tests (e.g., pelvic MRI); or formal MCC review. Results From November 2010 to May 2012, 20 surgeons (7 academic and 13 community) submitted 57 rectal cancer cases for I-CCC review. After I-CCC review, 30 of 57 (53 %) cases had treatment plan changes: 17 major and 13 minor. No patient or tumour factors predicted for treatment plan change. Conclusions An I-CCC for rectal cancer in a large geographic region was feasible and influenced surgeon treatment recommendations in 53 % of cases. Because no factor predicted for treatment plan change, it is likely prudent that all rectal cancer patients undergo some form of collaborative review.
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-014-4216-2