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Current Oncology
Volume 20
Issue 2
10.3747/co.20.1297
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Current Oncology is published by MDPI from Volume 28 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Multimed Inc..
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Article

Impact of a Single-Day Multidisciplinary Clinic on the Management of Patients with Liver Tumours

by
J. Zhang
1,
M.N. Mavros
1,
D. Cosgrove
2,
K. Hirose
1,
J.M. Herman
3,
S. Smallwood–Massey
1,
I. Kamel
4,
A. Gurakar
5,
R. Anders
6,
A. Cameron
1,
J.F.H. Geschwind
7 and
T.M. Pawlik
1,*
1
Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
2
Department of Medical Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
3
Department of Radiation Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
4
Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
5
Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
6
Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
7
Department of Interventional Radiology, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2013, 20(2), 123-131; https://doi.org/10.3747/co.20.1297
Submission received: 2 January 2013 / Revised: 4 February 2013 / Accepted: 5 March 2013 / Published: 1 April 2013

Abstract

Purpose: Multidisciplinary cancer clinics may improve patient care. We examined how a single-day multidisciplinary liver clinic (MDLC) affected care recommendations for patients compared with the recommendations provided before presentation to the MDLC. Methods: We analyzed the demographic and clinicopathologic data of 343 patients assessed in the Johns Hopkins Liver Tumor Center from 2009 to 2012, comparing imaging and pathology interpretation, diagnosis, and management plan between the outside provider (OSP) and the MDLC. Results: Most patients were white (n = 259, 76%); median age was 60 years; and 146 were women (43%). Outside providers referred 182 patients (53%); the rest were self-referred. Patients travelled median of 83.4 miles (interquartile range: 42.7–247 miles). Most had already undergone imaging (n = 338, 99%) and biopsy (n = 194, 57%) at the OSP, and a formal management plan had been formulated for about half (n = 168, 49%). Alterations in the interpretation of imaging occurred for 49 patients (18%) and of biopsy for 14 patients (10%). Referral to the MDLC resulted in a change of diagnosis in 26 patients (8%), of management plan in 70 patients (42%), and of tumour resectability in 7 patients (5%). Roughly half the patients (n = 174, 51%) returned for a follow-up, and 154 of the returnees (89%) received treatment, primarily intraarterial therapy (n = 88, 57%), systemic chemotherapy (n = 60, 39%), or liver resection (n = 32, 21%). Enrollment in a clinical trial was proposed to 34 patients (10%), and 21 of the 34 (62%) were accrued. Conclusions: Patient assessment by our multidisciplinary liver clinic had a significant impact on management, resulting in alterations to imaging and pathology interpretation, diagnosis, and management plan. The MDLC is an effective and convenient means of delivering expert opinion about the diagnosis and management of liver tumours.
Keywords: multidisciplinary care; single-day clinic; liver tumours; surgical oncology; interventional radiology multidisciplinary care; single-day clinic; liver tumours; surgical oncology; interventional radiology

Share and Cite

MDPI and ACS Style

Zhang, J.; Mavros, M.N.; Cosgrove, D.; Hirose, K.; Herman, J.M.; Smallwood–Massey, S.; Kamel, I.; Gurakar, A.; Anders, R.; Cameron, A.; et al. Impact of a Single-Day Multidisciplinary Clinic on the Management of Patients with Liver Tumours. Curr. Oncol. 2013, 20, 123-131. https://doi.org/10.3747/co.20.1297

AMA Style

Zhang J, Mavros MN, Cosgrove D, Hirose K, Herman JM, Smallwood–Massey S, Kamel I, Gurakar A, Anders R, Cameron A, et al. Impact of a Single-Day Multidisciplinary Clinic on the Management of Patients with Liver Tumours. Current Oncology. 2013; 20(2):123-131. https://doi.org/10.3747/co.20.1297

Chicago/Turabian Style

Zhang, J., M.N. Mavros, D. Cosgrove, K. Hirose, J.M. Herman, S. Smallwood–Massey, I. Kamel, A. Gurakar, R. Anders, A. Cameron, and et al. 2013. "Impact of a Single-Day Multidisciplinary Clinic on the Management of Patients with Liver Tumours" Current Oncology 20, no. 2: 123-131. https://doi.org/10.3747/co.20.1297

APA Style

Zhang, J., Mavros, M. N., Cosgrove, D., Hirose, K., Herman, J. M., Smallwood–Massey, S., Kamel, I., Gurakar, A., Anders, R., Cameron, A., Geschwind, J. F. H., & Pawlik, T. M. (2013). Impact of a Single-Day Multidisciplinary Clinic on the Management of Patients with Liver Tumours. Current Oncology, 20(2), 123-131. https://doi.org/10.3747/co.20.1297

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