European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology · 2025
Delivering a national accelerated HPB cancer management strategy: The pancreatic and hepatocellular cancer pathway improvement project (PHCC-PIP).
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Adair Anya, Urquhart Christine, Carter Ross
Аннотация
INTRODUCTION: Diagnostic delays impact pancreatic cancer (PC) and hepatocellular carcinoma (HCC) patients. The Pathway improvement project (PIP) aimed to address this, centralizing oversight of patient's staging pathways across Scotland, thereby streamlining diagnosis to definitive treatment and improving communication.
METHODS: A National cancer care team (CCT) received alerts from radiology departments for scans suspicious of PC or HCC. Timeline for intervention was from report of the initial investigation to commencing a patient's definitive treatment. Baseline data were established through the existing Regional MDT Network. Timeline steps were established as Key Performance indicators. These were compared to the prospectively collected data during the intervention of the PIP.
RESULTS: The retrospective audit included 387 patients with 277 patients included in the Prospective pilot. Time from image report to GP involvement (HCC p < 0.001: PC p = 0.001), CNS contact ((HCC p < 0.05: PC p = 0.025), MDT decision (HCC p = 0.023: PC p = 0.003) were all significantly improved. Median time from image report to commencing definitive treatment was reduced from 98 to 62 days for HCC patients (p = 0.001), and from 54 to 38 days for PC patients (p = 0.005).
CONCLUSION: This pilot delivered centralized ownership of patient's, reducing duration of the staging process and improving communication while using existing regional clinical pathways.
METHODS: A National cancer care team (CCT) received alerts from radiology departments for scans suspicious of PC or HCC. Timeline for intervention was from report of the initial investigation to commencing a patient's definitive treatment. Baseline data were established through the existing Regional MDT Network. Timeline steps were established as Key Performance indicators. These were compared to the prospectively collected data during the intervention of the PIP.
RESULTS: The retrospective audit included 387 patients with 277 patients included in the Prospective pilot. Time from image report to GP involvement (HCC p < 0.001: PC p = 0.001), CNS contact ((HCC p < 0.05: PC p = 0.025), MDT decision (HCC p = 0.023: PC p = 0.003) were all significantly improved. Median time from image report to commencing definitive treatment was reduced from 98 to 62 days for HCC patients (p = 0.001), and from 54 to 38 days for PC patients (p = 0.005).
CONCLUSION: This pilot delivered centralized ownership of patient's, reducing duration of the staging process and improving communication while using existing regional clinical pathways.