Author of

• 20177

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  P2.13 - Radiology/Staging/Screening (ID 714)

  • Event: WCLC 2017
  • Type: Poster Session with Presenters Present
  • Track: Radiology/Staging/Screening
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/17/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)

  • 24666

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    P2.13-026c - Impact of Lung Cancer Multidisciplinary Meeting Presentation on Quality of Life and Survival: A Victorian Retrospective Cohort Study (ID 8633)

    09:30 - 09:30  |  Author(s): C. McLean
    • Abstract

    Background:
    The creation of an effective management plan for non-small cell lung cancer (NSCLC) requires clinical and functional evaluation, a series of diagnostic and staging investigations and an evaluation of suitability for treatment. This process requires diverse multidisciplinary input and modern clinical guidelines therefore recommend presentation of all new lung cancer diagnoses to a multidisciplinary meeting (MDM) to facilitate evaluation and the development of an informed multidisciplinary management plan
    
    Method:
    We sought to evaluate the characteristics of patients presented to the lung cancer MDM and to evaluate the impact of MDM presentation on (i) management related outcomes including timeliness, supportive care screening, receipt of treatment and clinical trial participation, and (ii) patient related outcomes including survival and quality of life (QoL) in a metropolitan university teaching hospital.
    
    Result:
    In this cohort of cancer patients we found that just 59.6% of all new cancer diagnoses were presented to the lung cancer multidisciplinary meeting for clinical assessment and treatment planning despite the recommendation that all patients with lung cancer receive treatment in the context of a multidisciplinary setting. The likelihood of presentation was doubled for those with early clinical stage IA and halved for those with stage IV. Measures of quality of life (vitality and role emotion domain scores from the SF12v2) improved for those presented to the MDM between 3 and 12 months following presentation compared to those not presented. Advanced clinical stage was a strong predictor of mortality for all patients. MDM presentation conferred a significant crude protective effect on mortality for all patients (HR 0.63, 0.49-0.81; p<0.001) which was diminished when adjusted for confounding factors (0.79, 0.56-1.10;p=0.16), although this benefit was sustained for those with clinical stage IIIA (adjusted HR 0.31 0.12—0.79; p=0.01). The referral source for MDM presented patients were approximately one third from respiratory medicine, one third from lung cancer specialities and one third from medical and surgical specialty units with mortality risk increased for those referred by general medicine and surgical specialties.
    
    Conclusion:
    We found significant disparities in the utilisation of lung multidisciplinary meeting presentation which was associated with significant differences in uptake of active cancer therapy and ultimately survival. This study identifies significant benefit to those being presented to a lung cancer MDM and provides evidence to support multidisciplinary evaluation.