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PTH-006 Radiology reporting changes in the colorectal multidisciplinary team meeting: is patient management affected?
  1. M T Lacey1,
  2. P Bevis2,
  3. R Hallifax3,
  4. R Hopkins4,
  5. N Borley5,
  6. T Brooklyn6,
  7. J Wheeler5
  1. 1Department of Surgery, Gloucester Royal Hospital, Cheltenham, UK
  2. 2Department of Surgery, Bristol Royal Infirmary, Bristol, UK
  3. 3Department of Medicine, Gloucester Royal Hospital, Gloucester, UK
  4. 4Department of Radiology, Cheltenham General Hospital, Cheltenham, UK
  5. 5Department of Surgery, Cheltenham General Hospital, Cheltenham, UK
  6. 6Department of Gastroenterology, Cheltenham General Hospital, Cheltenham, UK

Abstract

Introduction The multidisciplinary team (MDT) is an established integral part of the National Cancer plan, its decisions forming the gold standard for cancer care. We investigated whether formally issued radiological reports were subsequently changed or added to at the colorectal MDT, and if this affected patient management.

Methods We prospectively identified all patients with a new diagnosis of colorectal cancer over a 3-month period. Copies of the radiological report due to be discussed were attained, and compared to any modifications or additions at the MDT to identify any potential changes in management of the patient.

Results A total of 105 patients (2:1 male to female ratio), with a median age of 65 years were reviewed. 16 of the 105 patients (15%) had their reports modified or added to.

13 patients (81%) of change patients had a change or modification that was considered major, impacting upon ultimate diagnosis and management. As a result three patients (23%) had their surgery cancelled and, two patients (15%) had their surgery delayed while awaiting further investigations. Two patients (15%) had a malignant finding changed to a benign and, three patients (23%) were changed to a curative resection having been previously considered as palliative. Two patients (15%) had the original curative procedure together with a distant plus another organ resection, and one patient (8%) had their surgery brought forward.

3 patients (19%) of change patients had a change or modification that was considered minor, having no impact upon their diagnosis or management.

Conclusion The MDT identifies a significant minority (12%) of patients with new cancers whose management is changed significantly by review of radiology.

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