Impact of a Single-Day Multidisciplinary Clinic on the Management of Pancreatic Cancer: 3-Year Update

Purpose/Objective(s)In a previous report, we observed that evaluation in a one-day multidisciplinary pancreatic cancer clinic resulted in a change in management recommendations in 23.6% of patients with presumed pancreatic cancer. Here we report updated 3-year results from this multidisciplinary pancreatic cancer clinic.Materials/MethodsRecords of 539 consecutive patients referred to the Johns Hopkins Pancreas Multidisciplinary Cancer Clinic (PMDC) were prospectively collected from November 2006 to August 2009. Cross-sectional imaging, pathology, and medical history were evaluated by a panel of radiation oncologists, medical oncologists, surgical oncologists, pathologists, diagnostic radiologists, and geneticists. Alterations in treatment recommendations between the referring institution and the multidisciplinary clinic were recorded and compared.ResultsOn presentation, the referring computed tomography (CT) report described unresectable/locally advanced disease in 29.3% of patients and metastatic disease in 11.4%. Upon review of submitted imaging and in-house imaging performed on the day of the PMDC, 16.9% of patients had a change in the status of their clinical stage. Review of histological slides by pathologists with expertise in the pancreas resulted in a change in the pathologic diagnosis for 5.9% of patients. Overall, 20.0% of patients had a change in their recommended management based on review of their case by the PMDC tumor board. Enrollment into the National Familial Pancreas Tumor Registry (NFPTR) increased from 52 out of 106 (49.2%) patients in 2005 to 325 out of 539 (60.3%).ConclusionsThe single-day multidisciplinary pancreatic cancer clinic provides a comprehensive and coordinated evaluation of patients that leads to a change in therapeutic recommendations for 20% of patients. Future research will determine whether these changes influence survival and whether they increase the temporal and fiscal efficiency of therapy administered. Purpose/Objective(s)In a previous report, we observed that evaluation in a one-day multidisciplinary pancreatic cancer clinic resulted in a change in management recommendations in 23.6% of patients with presumed pancreatic cancer. Here we report updated 3-year results from this multidisciplinary pancreatic cancer clinic. In a previous report, we observed that evaluation in a one-day multidisciplinary pancreatic cancer clinic resulted in a change in management recommendations in 23.6% of patients with presumed pancreatic cancer. Here we report updated 3-year results from this multidisciplinary pancreatic cancer clinic. Materials/MethodsRecords of 539 consecutive patients referred to the Johns Hopkins Pancreas Multidisciplinary Cancer Clinic (PMDC) were prospectively collected from November 2006 to August 2009. Cross-sectional imaging, pathology, and medical history were evaluated by a panel of radiation oncologists, medical oncologists, surgical oncologists, pathologists, diagnostic radiologists, and geneticists. Alterations in treatment recommendations between the referring institution and the multidisciplinary clinic were recorded and compared. Records of 539 consecutive patients referred to the Johns Hopkins Pancreas Multidisciplinary Cancer Clinic (PMDC) were prospectively collected from November 2006 to August 2009. Cross-sectional imaging, pathology, and medical history were evaluated by a panel of radiation oncologists, medical oncologists, surgical oncologists, pathologists, diagnostic radiologists, and geneticists. Alterations in treatment recommendations between the referring institution and the multidisciplinary clinic were recorded and compared. ResultsOn presentation, the referring computed tomography (CT) report described unresectable/locally advanced disease in 29.3% of patients and metastatic disease in 11.4%. Upon review of submitted imaging and in-house imaging performed on the day of the PMDC, 16.9% of patients had a change in the status of their clinical stage. Review of histological slides by pathologists with expertise in the pancreas resulted in a change in the pathologic diagnosis for 5.9% of patients. Overall, 20.0% of patients had a change in their recommended management based on review of their case by the PMDC tumor board. Enrollment into the National Familial Pancreas Tumor Registry (NFPTR) increased from 52 out of 106 (49.2%) patients in 2005 to 325 out of 539 (60.3%). On presentation, the referring computed tomography (CT) report described unresectable/locally advanced disease in 29.3% of patients and metastatic disease in 11.4%. Upon review of submitted imaging and in-house imaging performed on the day of the PMDC, 16.9% of patients had a change in the status of their clinical stage. Review of histological slides by pathologists with expertise in the pancreas resulted in a change in the pathologic diagnosis for 5.9% of patients. Overall, 20.0% of patients had a change in their recommended management based on review of their case by the PMDC tumor board. Enrollment into the National Familial Pancreas Tumor Registry (NFPTR) increased from 52 out of 106 (49.2%) patients in 2005 to 325 out of 539 (60.3%). ConclusionsThe single-day multidisciplinary pancreatic cancer clinic provides a comprehensive and coordinated evaluation of patients that leads to a change in therapeutic recommendations for 20% of patients. Future research will determine whether these changes influence survival and whether they increase the temporal and fiscal efficiency of therapy administered. The single-day multidisciplinary pancreatic cancer clinic provides a comprehensive and coordinated evaluation of patients that leads to a change in therapeutic recommendations for 20% of patients. Future research will determine whether these changes influence survival and whether they increase the temporal and fiscal efficiency of therapy administered.