Author of

• 12853

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  P3.24 - Poster Session 3 - Supportive Care (ID 160)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Supportive Care
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12885

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    P3.24-032 - Second opinion for thoracic cancer and its impact on diagnosis and treatment strategy: a single institutional series (ID 1950)

    09:30 - 09:30  |  Author(s): B.I. Hiddinga
    • Abstract

    Background
    Lung cancer patients increasingly seek a second opinion in order to make sure they are receiving an exact diagnosis and an optimal treatment. A second opinion is more likely to be comprehensive when performed in centers with high level of expertise and within a multidisciplinary team.

    Methods
    A dedicated second opinion outpatient clinic was started within the Thoracic Oncology Unit of Ghent University Hospital, in March 2012, aiming at a quick access and evaluating its impact on diagnosis and treatment decisions. Second opinion was defined as a review of the cancer diagnosis and/or the treatment recommendations by another independent oncologist and/or multidisciplinary team. Patients had to be referred by either their general practitioner or the treating specialist. Prior to the consultation relevant investigations (medical history, pathology and imaging) had to be provided.

    Results
    Between March 2012 and June 2013, 79 pts were referred: 31 women and 48 men with a median age of 64 years [17-81 yrs]. Of these, 17 (22%) were never smokers, 18 (23%) smokers and 40 (51%) ex-smokers. Median interval was 3 working days [0-15 days] after first referral. Eighteen percent of patients were referred by their GP’s versus 80% by their treating specialist. Medical information including imaging was available in all pts at the moment of the consultation. Diagnosis included: adenocarcinoma (n=43 - 54%), squamous cell carcinoma (n=8 - 10%), NSCLC, NOS (n=1 large cell neuroendocrine carcinoma (n=3 - 4%), small cell lung cancer (n=4 - 5%), mesothelioma (n=6 - 8%), thymoma (n=2 - 3%), carcinoid tumor (n= 4 - 5%). In 4 patients no diagnosis had been established. Eleven patients were referred for confirmation of diagnosis and treatment, 11 for staging and 57 for treatment advice. Median consultation duration was 35 minutes [15-60 min], median time of multidisciplinary counseling 15 minutes [5-60 min]. In 43% of the referrals, diagnosis and treatment was confirmed, in 21% other diagnostic examinations were advised and in 29% a substantial change in treatment was proposed. Six percent of patients entered into a clinical trial. Almost 50% of patients continued their treatment at our center (26% on request of the referring physician, 23% on patient's request). Patient's satisfaction on waiting time and quality of the advice was high.

    Conclusion
    This dedicated second opinion outpatient clinic confirms the need for an academic second medical advice and provided a quick access. In 50% of cases a substantial change in diagnostic procedure or treatment was proposed.